• 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.41 no.4
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• pp.335-343
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• 2014

Regenerative endodontic treatment has the potential to heal a necrotic pulp, which can affect root development in immature teeth. However, several drawbacks and unfavorable outcomes are associated with regenerative endodontic treatment, of which the most significant is coronal discoloration due to the presence of minocycline in triple antibiotic paste and mineral trioxide aggregate (MTA). To prevent tooth discoloration following pulp treatment, the modified triple antibiotics (ciprofloxacin, metronidazole, clindamycin) were used as canal disinfectants and Retro MTA, a $ZrO_2$-containing calcium aluminate cement, was used to seal the canal. Following access cavity acquisition, the canal was copiously irrigated with 2.5% sodium hypochlorite. A modified triple antibiotic paste was then applied to the canal. Once the tooth was asymptomatic (after between 3 and 8 weeks), Retro MTA was carefully placed over the blood clot or a collagen plug. Follow-up radiographs revealed normal periodontal ligament space and root development. In two cases, successful regenerative endodontic treatment of the infected immature tooth, without discoloration, was achieved with disinfection using modified triple antibiotics and Retro MTA sealing.

• 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.

• Korean Journal of Veterinary Research
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• v.17 no.1
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• pp.1-4
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• 1977

Two hundred and twenty-seven strains of Escherichia coli isolated from 25 hens (12 hens received tetracycline neomycin and sulfadimethoxine, and 13 hens not received antibiotics) were studied for the drug resistance and distribution of R factors. About 74 per cent of E. coli strains isolated from hens of a herd received antibiotics were resistance to tetracycline (TC) streptomycin (SM), chloramphenicol (CM), kanamycin (KM), ampicillin (AP) and sulfisomidine (Su), alone or in combination thereof, but only a hen among a herd not received antibiotics excreted E. coli resistant to TC and SM. Among resistant strains, about 7% were found to be resistant to TC and SM, whereas 93% were resistant to three or more antibiotics. The most common pattern was the quadruple resistant to SM, TC, KM and Su (28.7%), and followed by triple ones to SM, TC and Su (25.3%), and SM, TC and KM (24.7%). About 84% of resistant strains carried R factors which were transferable to the recipient by conjugation.

• Korean Journal of Veterinary Research
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• v.17 no.1
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• pp.5-8
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• 1977

One hundred and fifty seven Escherichia coli strains isolated from 18 cattle (9 dairy cattle received penicillin, streptomycin (SM) or sulfadimethoxine for treatment of diseases and 9 Korean native cattle not received antibiotics) were studied for the drug resistance and distribution of R factors. Of 88 E. coli strains isolated from cattle not received antibiotics, only 1 strain was resistant to SM, but about 46 per cent of 69 E. coli strains isolated from cattle received antibiotics were resistant to SM, tetracycline (TC), ampicillin (AP), kanamycin (KM), chloramphenicol (CM), and sulfisomidine (Su), alone or in combination thereof. Of resistant strains, about 72% were resistant to three or more antibiotics, but 28% were found to singly resistant. The most frequent resistant pattern was triple resistance to AP, KM and Su (37.6%), and quadruple one to SM, TC, CM and Su (12.5%). About 28% of resistant strains carried R factors which were transferable to E. coli ML 1410 $NA^r$ by conjugation.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.3
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• pp.216-222
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• 2013

Paradigm shift in management of infected immature permanent teeth has occurred. The new concept of the treatment includes minimal or no intracanal instrumentation, disinfection with triple antibiotic paste and sealing with mineral trioxide aggregate. This regenerative endodontic treatment promotes differentiation of periradicular stem cells that induce regeneration of vital tissue and continuation of root formation. Thorough disinfection and three-dimensional scaffold are important in this new concept of the treatment. Platelet-rich fibrin has been reported as 'new scaffold' instead of blood clot, which had been used in the past. Triple antibiotics can be used to disinfect the tooth but may lead to complications including discoloration. Three cases of infected immature permanent tooth caused by dens evaginatus fracture are presented. After removal of necrotic pulp and thorough intracanal irrigation, only platelet-rich fibrin was applied to the root canal in the first case. In the other cases, topical antibiotics was used for disinfection and platelet-rich fibrin for scaffold. In all the cases, the opening was sealed with mineral trioxide aggregate. All the cases showed proper healing of inrabony lesion and some lengthening of root. According to these cases, regenerating vital tissue of the infected immature permanent tooth can be achieved with disinfection and application of platelet-rich fibrin.

• Korean Journal of Clinical Laboratory Science
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• v.38 no.3
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• pp.166-172
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• 2006

Metallo-${\beta}$-lactamase (MBL) can hydrolyze all ${\beta}$-lactams except monobactams and frequently coexists with various antibiotic resistance genes such as aminoglycoside resistance, sulfonamide resistance gene, etc. Therefore, the effective antibiotics against infections by these bacteria are markedly limited or can't even be found. We tried to search in-vitro antimicrobial combinations with synergistic effects for a VIM-2 type MBL producing Pseudomonas aeruginosa, isolated from clinical specimen. On the selection of antibiotic combinations with synergistic effects, we performed a one disk synergy test, modified Pestel's method, in agar without aztreonam (AZT). The bacteriostatic synergistic effects of this tests were scored as $S_1$ (by susceptibility pattern in agar without antibiotics), $S_2$ (by the change of susceptibility in agar with or without antibiotics) and $S_3$ ($S_1$ + $S_2$) and was classified into weak (1 point), moderate (2 points) and strong (3 points) by $S_3$ score. Subsequently, we carried out the time-killing curve for the antibiotic combinations with the strong synergistic bacteriostatic effect. One VIM-2 type MBL producing P. aeruginosa confirmed by the PCR showed all resistance against all ${\beta}$-lactams except AZT, aminoglycoside and ciprofloxacin. In the one disk synergy test, this isolate showed a strong bacteriostatic synergistic effect for the antibiotic combination of AZT and piperacillin-tazobactam (PIP-TZP) or AZT and amikacin (AN). On the time-killing curve after six hours of incubation, the colony forming units (CFUs/mL) of this bacteria in the medium broth with both combination antibiotics were decreased to 1/18.7, 1/17.1 of the least CFUs of each single antibiotics. The triple antibiotic combination therapy including AZT, PIP-TZP and AN was shown to be significantly synergistic after 8 hrs of exposure. In a VIM-2 MBL producing P. aeruginosa with susceptibility for AZT, the triple antibiotic combination therapy including AZT, PIP-TZP and AN may be considered as an alternative antibiotics modality against the infection by some MBL type. But the antimicrobial combination therapy for many more MBL producing isolates is essential to know as soon as possible for the selection of effective treatment against the infection by this bacteria.

• Journal of Forest and Environmental Science
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• v.22 no.1
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• pp.83-100
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• 2006

Antibiotics which produced by mushrooms discovered for last 40 years were described. Any antibiotic has not been used as infectious disease remudy but will be used as physiological active substance in near future. The antibiotic of mushrooms have not been published much in papers and do not have various finds of structures, compared to those of Streptomyces. Triple bond having compounds, terpenoid compounds aromatic compounds and some other compound have been known. These compounds are not dissolved well in water and mainly fat-soluble, except for cordycepin. Also, they are generally neutral, and some of them are acidic and almost none of them are basic compounds. However, acetylene and terpenoid compounds are the characteristic compounds of mushroom, and are not found in other microorganisms and plants. Especially, there are various terpenoid compounds in mushrooms. These metabolites of mushrooms were not used as antibiotic, but are interested as physiological active substance, such as enzyme inhibitor and immunomodulator. To promote studying on the antibiotics of mushroom, new screening methods must be developed, because strain belonged to the different genus produces different antibiotics, even though mushrooms belonged to the same genus and species. It is also known that mushrooms collected in different areas produce different antibiotics. Now, it is difficult to separate each pure compound from mushroom. It is important to find mushrooms which is impossible to cultivate artificially, or grow in the back land where is difficult to collect. Thousands of mushrooms grow on earth now, so that which species will be screened if not known. The biochemical and mycological study for usability of the metabolites of mushrooms is thought, as one of the important research areas, must be performed.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.28.1-28.16
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• 2018

This study investigated the latest findings and notions regarding 'triple antibiotic paste' (TAP) and its applications in dentistry, particularly endodontics. TAP is a combination of 3 antibiotics, ciprofloxacin, metronidazole, and minocycline. Despite the problems and pitfalls research pertaining to this paste has unveiled, it has been vastly used in endodontic treatments. The paste's applications vary, from vital pulp therapy to the recently introduced regeneration and revascularisation protocol. Studies have shown that the paste can eliminate the root canal microorganisms and prepare an appropriate matrix for further treatments. This combination is able to remove diverse groups of obligate and facultative gram-positive and gram-negative bacteria, providing an environment for healing. In regeneration protocol cases, this allows the development, disinfection, and possible sterilization of the root canal system, so that new tissue can infiltrate and grow into the radicular area. Moreover, TAP is capable of creating a discipline in which other wanted and needed treatments can be successfully performed. In conclusion, TAP, as an antibacterial intracanal medication, has diverse uses. Nevertheless, despite its positive effects, the paste has shown drawbacks. Further research concerning the combined paste and other intracanal medications to control microbiota is a must.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.192-198
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• 2012

Revascularization of the pulp in a necrotic, infected immature tooth with apical periodontitis was attempting several years. Revascularization of partially necrotic pulp in an immature tooth is based on the concept that vital dental stem cells can survive pulpal necrosis. Revascularization procedure obtains longer and thicker roots in teeth with necrotic pulp diagnosis. Pulp revascularization for immature permanent molars can be possibly applied on cases having difficulty to use conventional root canal treatment due to abnormally thin root canal wall or severe root curvature. Also, when an uncooperative patient does not agree with sedative treatment the revascularization can be useful. And a patient with disability who is barely cooperative can be another indication of this treatment. In this case report, pulp revascularization using triple-antibiotics, metronidazole, ciprofloxacine and minocycline, was applied on the immature first permanent molar infected by caries.