Ana Moura Teles¹, Rebecca Lassarat², Cristina Pina¹ and Inês Lopes Cardoso¹*

¹FP-I3ID - Institute of Investigation, Innovation and Development Fernando Pessoa, Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
²Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal

*Corresponding Author:Inês Lopes Cardoso, FP-I3ID - Institute of Investigation, Innovation and Development Fernando Pessoa, Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal.

Received: December 15, 2022; Published: December 28, 2022

Abstract

Non-Surgical Endodontic Treatment consists in the removal of dental pulp and the elimination of microorganisms that cause infection of the pulp space. This treatment can be performed in a single or in multiple sessions and, sometimes, the use of Intracanal Medication may be necessary. The purpose of Intracanalar Medication is to reach bacteria present in places inaccessible to instrumentation or irrigants and, also, to inhibit the invasion of the root canal system by bacteria or its products by coronal, lateral or apical communications with the outside through dentinal tubules, apical foramen or accessories root canals.
. The present work is a narrative review of the Literature that aims to analyse the different opinions among authors, in the case of permanent mature teeth with diagnosis of necrosis with or without apical periodontitis associated, and to understand in which situations it is necessary to apply Intracanal Medication, which should be chosen and how it should be applied. In this way, it is also intended that this work can be a useful guide for clinicians.

Keywords: Inês Lopes Cardoso, FP-I3ID - Institute of Investigation, Innovation and Development Fernando Pessoa, Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal.

References

1. Teles AM., et al. “Microorganisms: the reason to perform Endodontics. In: Microbial pathogens and strategies for combating them: science, technology and education (1778-1786)”. Formatex Research Center (2013).
2. Davido N and Yasukawa K. “Odontologie Conservatrice et Endodontie Odontologie prothétique”. Maloine (2017).
3. Sundqvist G and Figdor D. “Life as an Endodontic pathogen: Ecological differences between the untreated and root‐filled root canals”. Endodontic Topics1 (2003): 3-28.
4. Sathorn C., et al. “Effectiveness of single‐versus multiple‐visit Endodontic treatment of teeth with apical periodontitis: a systematic review and meta‐analysis”. International Endodontic Journal6 (2005): 347-355.
5. Paredes-Vieyra J and Enriquez FJJ. “Success rate of single-versus two-visit root canal treatment of teeth with apical periodontitis: a randomized controlled trial”. Journal of Endodontics9 (2012): 1164-1169.
6. Vera J., et al. “One-versus two-visit Endodontic treatment of teeth with apical periodontitis: a histobacteriologic study”. Journal of Endodontics8 (2012): 1040-1052.
7. Kawashima N., et al. “Root canal medicaments”. International Dental Journal1 (2009): 5-11.
8. Ordinola‐Zapata R., et al. “Present status and future directions of intracanal medicaments”. International Endodontic Journal3 (2022): 613.
9. Artaza L., et al. “Clinical and radiographic outcome of the root canal treatment of infected teeth with associated sinus tract: a retrospective study”. Australian Endodontic Journal 47 (2021): 599-607.
10. Segura-Egea JJ., et al. “Antibiotics in Endodontics: a review”. International Endodontic Journal12 (2017): 1169-1184.
11. Duboisdendien J. “L'antibiothérapie locale en endodontie: est-elle toujours d'actualité?” Chirurgie (2015): dumas-01158647.
12. Mohammadi Z and Abbott PV. “On the local applications of antibiotics and antibiotic‐based agents in Endodontics and dental traumatology”. International Endodontic Journal7 (2009): 555-567.
13. Segura‐Egea JJ., et al. “European Society of Endodontology position statement: the use of antibiotics in endodontics”. International Endodontic Journal1 (2018): 20-25.
14. Athanassiadis B., et al. “The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in Endodontics”. Australian Dental Journal52 (2007): S64-S82.
15. Haapasalo HK., et al. “Inactivation of local root canal medicaments by dentine: an in vitro study”. International Endodontics Journal2 (2000): 126-131.
16. Siqueira JF. “Treatment of Endodontic Infections”. Quintessence Publishing (2011).
17. Mohammadi Z., et al. “Antimicrobial activity of calcium hydroxide in Endodontics: a review”. Chonnam Medical Journal3 (2012): 133-140.
18. Fava LR and Saunders WP. “Calcium hydroxide pastes: Classification and clinical indications”. International Endodontics Journal4 (1999): 257-282.
19. Machado MEL., et al. “Antimicrobial effect of two endodontic medicaments with different exposure times, and the morphologic alterations caused to Enterococcus faecalis”. Revista Odonto Ciência 26 (2011): 336-340.
20. Ozyurek EU., et al. “Effect of calcium hydroxide dressing on the dentinal tubule penetration of 2 different root canal sealers: A confocal laser scanning microscopy study”. Journal of Endodontics 44 (2018): 1018-1023.
21. Capar I., et al. “Effect of different final irrigation methods on the removal of calcium hydroxide from an artificial standardized groove in the apical third of root canals”. Journal of Endodontics 40 (2014): 451-454.
22. Cohen S. “Cohen’s - Pathways of The Pulp”. 10^th edition. Mosby Elsevier (2011).
23. Pal H., et al. “Application of intracanal medicaments: a review”. Journal of Dental Medical Science1 (2019): 14-21.
24. Paquette L., et al. “Antibacterial efficacy of chlorhexidine gluconate intracanal medication in vivo”. Journal of Endodontics7 (2007): 788-795.
25. Lima KC., et al. “Susceptibilities of Enterococcus faecalis biofilms to some antimicrobial medications”. Journal of Endodontics10 (2001): 616-619.
26. Ehrmann EH., et al. “The relationship of intracanal medicaments to postoperative pain in endodontics”. International Endodontic Journal12 (2003): 868-875.
27. Kim ST., et al. “The effects of Ledermix paste on discolouration of mature teeth”. International Endodontic Journal3 (2000): 227-232.
28. Molander A and Dahlén G. “Evaluation of the antibacterial potential of tetracycline or erythromycin mixed with calcium hydroxide as intracanal dressing against Enterococcus faecalis in vivo”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics6 (2003): 744-750.
29. Chen BKJ., et al. “Root discolouration following short term application of steroid medicaments containing clindamycin, doxycycline or demeclocycline”. Australian Endodontics Journal3 (2012): 124-128.
30. Attia DA., et al. “Antimicrobial effect of different intracanal medications on various microorganisms”. Tanta Dental Journal1 (2015): 41-47.
31. Eftekhar B., et al. “Analgesic effect of Odontopaste and a compound intracanal medicament between root canal therapy appointments”.Jundishapur Journal of Natural Pharmaceutical Products4 (2013): 169-174.
32. Parhizkar A., et al. “Triple antibiotic paste: momentous roles and applications in Endodontics: a review”. Restorative Dentistry and Endodontics 3 (2018): e28.
33. Althumairy RI., et al. “Effect of dentin conditioning with intracanal medicaments on survival of stem cells of apical papilla”. Journal of Endodontics 40 (2014): 521-525.
34. Berkhoff JA., et al. “Evaluation of triple antibiotic paste removal by different irrigation procedures”. Journal of Endodontics8 (2014): 1172-1177.
35. Wei X., et al. “Expert consensus on regenerative endodontic procedures”. International Journal of Oral Science1 (2022): 1-13.
36. Park HB., et al.“Treatment of non-vital immature teeth with amoxicillin-containing triple antibiotic paste resulting in apexification”. Restorative Dentistry and Endodontics4 (2015): 322-327.
37. Samuni Y., et al. “The chemistry and biological activities of N-acetylcysteine”. Biochimica et Biophysica Acta 1830 (2013): 4117-4129.
38. Dinicola S., et al. “N-acetylcysteine as powerful molecule to destroy bacterial biofilms. A systematic review”. European Review for Medical and Pharmacological Sciences 18 (2014): 2942-2948. 
39. Choi YS., et al. “Removal and killing of multispecies endodontic biofilms by N-acetylcysteine”. Brazilian Journal of Microbiology 49 (2018): 184-188. 
40. Martinho FC., et al. “Impact of N-acetylcysteine (NAC) and calcium hydroxide intracanal medications in primary endodontic infection: a randomized clinical trial”. Clinical Oral Investigations 1 (2022): 1.
41. Teles AM., et al. “Effectiveness of two intracanal dressings in adult Portuguese patients: a qPCR and anaerobic culture assessment”. International Endodontics Journal1 (2014): 32-40.
42. Plutzer B., et al. “Comparative efficacy of endodontic medicaments and sodium hypochlorite against Enterococcus faecalis biofilms”. Australian Dental Journal2 (2018): 208-216.
43. Athanassiadis M., et al. “The effect of calcium hydroxide on the steroid component of Ledermix^® and Odontopaste^®”. International Endodontics Journal12 (2011): 1162-1169.
44. Jarrett J., et al. “Development of techniques for determination of primary components of dental medicament paste mixtures for root canal treatment”. Journal of Investigative and Clinical Dentistry2 (2018): e12294.
45. Gomes BPFA., et al. “In vitro evaluation of the antimicrobial activity of calcium hydroxide combined with chlorhexidine gel used as intracanal medicament”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics4 (2006): 544-550.
46. Cook J., et al. “Molecular-and culture-based comparison of the effects of antimicrobial agents on bacterial survival in infected dentinal tubules”. Journal of Endodontics6 (2007): 690-692.
47. Ballal V., et al. “Antimicrobial action of calcium hydroxide, chlorhexidine and their combination on Endodontic pathogens”. Australian Dental Journal2 (2007): 118-121.
48. Endo MS., et al. “Quantitative and qualitative analysis of microorganisms in root-filled teeth with persistent infection: Monitoring of the endodontic retreatment”. European Journal of Dentistry3 (2013): 302-309.
49. Ferrer-Luque CM., et al. “Residual activity of cetrimide and chlorhexidine on Enterococcus faecalis-infected root canals”. International Journal of Oral Sciences1 (2014): 46-49.
50. Ozan Ü and Er K. “Endodontic treatment of a large cyst-like periradicular lesion using a combination of antibiotic drugs: a case report”.Journal of Endodontics12 (2015): 898-900.
51. Er K., et al. “Nonsurgical Endodontic treatment of dens invaginatus in a mandibular premolar with large periradicular lesion: a case report ”. Journal of Endodontics3 (2007): 322-324.
52. Taneja S and Kumari M. “Use of triple antibiotic paste in the treatment of large periradicular lesions”. Journal of Investigative and Clinical Dentistry1 (2012): 72-76.
53. Kim D and Kim E. “Antimicrobial effect of calcium hydroxide as an intracanal medicament in root canal treatment: a literature review-Part I. In vitro studies”. Restorative Dentistry and Endodontics4 (2014): 241-252.
54. Dhillon JS., et al. “Healing of a large periapical lesion using triple antibiotic paste and intracanal aspiration in nonsurgical Endodontic retreatment”. Indian Journal of Dentistry3 (2014): 161-165.
55. Arruda MEF., et al. “Infection control in teeth with apical periodontitis using a Triple Antibiotic Solution or Calcium Hydroxide with Chlorhexidine: A randomized clinical trial”.Journal of Endodontics10 (2018): 1474-1479.
56. Beer R., et al. “Endodontia: Texto e Atlas”. In Endodontia: Texto e Atlas, Artmed Ed (2006).
57. Martinho FC., et al. “Clinical comparison of the effectiveness of 7 and 14-day intracanal medications in root canal disinfection and inflammatory cytokines”. Clinical Oral Investigation1 (2018): 523-530.
58. Sedgley CM., et al. “Influence of irrigant needle depth in removing bioluminescent bacteria inoculated into instrumented root canals using real‐time imaging in vitro”. International Endodontics Journal2 (2005): 97-104.
59. Chou K., et al. “Effectiveness of different intracanal irrigation techniques in removing intracanal paste medicaments”. Australian Endodontic Journal1 (2014): 21-25.
60. Afkhami F., et al. “Discoloration of teeth due to different intracanal medicaments”. Restorative Dentistry and Endodontics1 (2019): e10.
61. Reynolds K., et al. “Pulp revascularization of necrotic bilateral bicuspids using a modified novel technique to eliminate potential coronal discolouration: a case report”. International Endodontic Journal1 (2009): 84-92.
62. Arslan H., et al. “Efficacy of needle irrigation, EndoActivator, and photon-initiated photoacoustic streaming technique on removal of double and triple antibiotic pastes”. Journal of Endodontics9 (2014): 1439-1442.
63. El Karim I., et al. “The antimicrobial effects of root canal irrigation and medication”. Endodontology4 (2007): 560-569.

Citation

Citation: Inês Lopes Cardoso., et al. “Intracanal Medication as Antibiotic Control in Case of Permanent Mature Teeth with Necrotic Pulp or Apical Periodontitis".Acta Scientific Dental Sciences 7.1 (2023): 98-109.

Copyright

Copyright: © 2023 Inês Lopes Cardoso., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.