• Restorative Dentistry and Endodontics
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• v.37 no.2
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• pp.119-122
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• 2012

Regenerative endodontics has a potential to heal a partially necrotic pulp, which can be beneficial for the continued root development and strengthening of immature teeth. For this purpose, triple antibiotic mixture of ciprofloxacin, metronidazole, and minocycline was recommended as intracanal medicament in an attempt to disinfect the root canal system for revascularization of a tooth with a necrotic pulp. However, discoloration of the tooth was reported after applying this. This case shows the idea for preventing the tooth discoloration using a delivery syringe to avoid the contact between the clinical crown and the antibiotics.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.43-50
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• 2012

The concept of revascularization of necrotic pulps regained interest and became an alternative conservative treatment option for young permanent teeth with immature roots. Revascularization of immature teeth with apical periodontitis depends mainly on disinfection of the canal. Since the infection of the root canal system is considered to be polymicrobial, a combination of drugs would be needed to treat the diverse flora. A triple antibiotic mixture of metronidazole, ciprofloxacin, and minocycline was used as an intracanal medicament. However, discoloration was developed after applying the triple antibiotic mixture. It is believed that the marked discoloration is related to the use of minocycline. The aim of this article was to present cases of coronal discoloration after triple antibiotic therapy in immature tooth and was treated with bleaching technique to control coronal discoloration. In conclusion, revascularization by using triple antibiotics promotes a paradigm shift in treating endodontically involved permanent teeth. However, we should understand that triple antibiotics containing minocycline induces tooth discoloration. Further research to prevent coronal discoloration should be investigated and suggested for the safe use of triple antibiotics.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.174-180
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• 2012

In case of an immature tooth with necrotic pulp, regeneration of pulp tissue into a canal would be the ideal outcome. It may be capable of promoting the continuation of normal root development. Platelet-rich fibrin has been suggested as a potentially ideal scaffold for regenerative endodontic treatment. Immature permanent teeth of young children were diagnosed with pulp necrosis and apical abscess as the result of clinical and radiographic examination. After removal of necrotic pulp, canal was irrigated with 5.25% NaOCl and dried with paper point. A triple antibiotic mixture was placed in canal space in 3 weeks. After removal of the antibiotic mixture, the platelet-rich fibrin was injected into the canal space with MTA placed directly over the platelet-rich fibrin clot. The coronal region was restored by composite resin. On the basis of short-term results of the present 3 cases, regeneration of vital tissues appears to be possible in a tooth with necrotic pulp and a periapical lesion. Also, platelet-rich fibrin proves to be potentially an ideal scaffold for this procedure. Therefore, long-term clinical observation and examination about this treatment using platelet-rich fibrin in immature permanent teeth of young children are considered to be necessary.

• Restorative Dentistry and Endodontics
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• v.44 no.1
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• pp.10.1-10.11
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• 2019

Objectives: The objective of this study was to assess coronal discoloration induced by the following intracanal medicaments: calcium hydroxide (CH), a mixture of CH paste and chlorhexidine gel (CH/CHX), and triple antibiotic paste (3Mix). Materials and Methods: Seventy extracted single-canal teeth were selected. Access cavities were prepared and each canal was instrumented with a rotary ProTaper system. The specimens were randomly assigned to CH, CH/CHX, and 3Mix paste experimental groups (n = 20 each) or a control group (n = 10). Each experimental group was randomly divided into 2 subgroups (A and B). In subgroup A, medicaments were only applied to the root canals, while in subgroup B, the root canals were completely filled with medicaments and a cotton pellet dipped in medicament was also placed in the pulp chamber. Spectrophotometric readings were obtained from the mid-buccal surface of the tooth crowns immediately after placing the medicaments (T1) and at 1 week (T2), 1 month (T3), and 3 months (T4) after filling. The ${\Delta}E$ was then calculated. Data were analyzed using 2-way analysis of variance (ANOVA), 3-way ANOVA, and the $Scheff{\acute{e}}$ post hoc test. Results: The greatest color change (${\Delta}E$) was observed at 3 months (p < 0.0001) and in 3Mix subgroup B (p = 0.0057). No significant color change occurred in the CH (p = 0.7865) or CH/CHX (p = 0.1367) groups over time, but the 3Mix group showed a significant ${\Delta}E$ (p = 0.0164). Conclusion: Intracanal medicaments may induce tooth discoloration. Use of 3Mix must be short and it must be carefully applied only to the root canals; the access cavity should be thoroughly cleaned afterwards.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.4
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• pp.455-463
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• 2018

The purpose of this study was to evaluate the effect of the intracanal medicaments on the push-out bond strength of the calcium silicate-based materials. Forty extracted single-root human mandibular premolars were sectioned below cementoenamel junction. Standardized root canal dimension was obtained with a parallel post drill. The specimens were randomly divided into a control group (no medicament), and experimental groups received medicaments with either CH (calcium hydroxide), DAP (double antibiotic paste; a mixture of ciprofloxacin and metronidazole), or TAP (triple antibiotic paste; a mixture of minocycline, ciprofloxacin and metronidazole). Following removal of medicaments with irrigation, roots were cut into sections with 1-mm-thickness. Thereafter, calcium silicate-based materials are applied to the specimens : (i) ProRoot MTA$^{(R)}$ and (ii) Biodentine$^{(R)}$. A push-out bond strength was measured and each specimen was examined to evaluate failure mode. Intracanal medication using CH significantly increased the bond strength to the root dentin. But there are no significant differences on the bond strength of ProRoot MTA$^{(R)}$ or Biodentine$^{(R)}$ among TAP, DAP and control groups. The dislodgement resistance of Biodentine$^{(R)}$ from root dentin was significantly higher than that of ProRoot MTA$^{(R)}$ regardless of the type of intracanal medicaments.