Pulp Therapy in Primary Teeth with Three Mix Antibiotics
Recently, there has been a relatively new biological concept in the treatment of dental caries, called lesion sterilization and tissue repair therapy, that employs the use of three mix antibiotics: namely, metronidazole, ciprofloxacin, and minocycline. The clinical advantage of this procedure is its simple techniqe. No instrumentation is needed, thus reducing chair time and only one visit is required for treatment. Therefore, pulp treatment in primary teeth with three mix antibiotics may be an optional treatment for an uncooperative child patient. This review collects the studies relating to this treatment modality in primary teeth and should be beneficial for clinicians practicing pediatric dentistry.
1. Levine N, Pulver F, Torneck CD. Pulpal therapy in primary and young permanent teeth. In: Wei SHY, ed: Pediatric dentistry: Total patient care, 1st ed. Philadephia: Lea& Febiger; 1988: 298.
2. Trairatvorakul C, Chanthorn P, Tanpatanan P. Why dentists in the universal health coverage program are unable to provide same services in the dental benefits according to indications. J Dent Assoc Thai 2005; 55: 63-77. (in Thai)
3. Takushige T, Cruz EV, Asgor Moral A, Hoshino E. Endodontic treatment of primary teeth using a combination of antibacterial drugs. Int Endod J 2004; 37: 132-138.
4. Hoshino E. Predominant obligate anaerobes in human carious dentin. J Dent Res 1985; 64(10): 1195-1198.
5. Hoshino E, Ando N, Sato M, Kota K. Bacteria invasion of non-exposed dental pulp. Int Endod J 1992; 25(1): 2-5.
6. Ando N, Hoshino E. Predominant obligate anaerobes invading the deep layers of root canal dentine. Int Endod J 1990; 23: 20-27.
7. Sato T, Hoshino E, Uematsu T, Noda T. In vitro antimicrobial susceptibility to combinations of drugs of bacteria from carious and endodontic lesions of human deciduous teeth. Oral Microbial Immunol 1993; 8: 172-176.
8. Kiryu T, Hoshino E, Kota K. Bacteria invading periapical cementum. J Endod 1994; 20: 169- 172.
9. Windley W, Teixeira L, Levin L, Sigurdsson A, Trope M. Disinfection of immature teeth with a triple antibiotic paste. J Endod 2005; 31(6): 439-443.
10. Hoshino E, Kota K, Sato M, Iwaku M. Bactericidal efficacy of metronidazole against bacteria of human carious dentin in vitro. Caries Res 1988; 22(5): 280-282.
11. Hoshino E, Iwaku M, Sato M, Ando N, Kota K. Bactericidal efficacy of metronidazole against bacteria of human carious dentin in vivo. Caries Res 1989; 23(2): 78-80.
12. Hoshino E, Kota K, Iwaku M. Sterilization of carious lesions by antibacterial drugs. New attempt to conserve pulp. The basic approach. J Dent Outlook 1990; 75: 1379-1389. Cited by Sato T, Hoshino E, Uematsu T, Noda T. In vitro antimicrobial susceptibility to combinations of drugs of bacteria from carious and endodontic lesions of human deciduous teeth. Oral Microbial Immunol 1993; 8: 172-176.
13. Bhanot SK, Singh M, Chatterjee NR. The chemical and biological aspects of fluoroquinolones: reality and dreams. Cur Pharm Des 2001; 7(5): 311-315.
14. Hoshino E, Kurihara-Ando N, Sato I, Uematsu H, Sato M, Kota K, Iwaka M. In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J 1996; 29: 125-130.
15. Sato I, Ando-kurihara N, Kota K, Iwaku M, Hoshino E. Sterilization of infected root-canal dentine by topical application of a mixture of ciprofloxacin, metronidazole and minocycline in situ. Int Endod J 1996; 29: 118-124.
16. Ayukawa Y. Pulpal response of human teeth to antibacterial biocompatible pulp-capping agent improvement of mixed drugs. Japanese Journal of Conservative Dentistry 1994; 37: 643-651. Cited by Hoshino E, Kurihara-Ando N, Sato I, Uematsu H, Sato M, Kota K, Iwaka M. In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J 1996; 29: 125-130.
17. Fava LRG, Saunders WP. Calcium hydroxide pastes: classification and clinical indications. Int Endod J 1999; 32: 257-282.
18. Cruz EV, Kota K, Huque J, Iwaku M, Hoshino E. Prenetration of propylene glycol into dentine. Int Endod J 2002; 35: 330-336.
19. El Karim I, Kennedy J, Hussey D. The antimicrobial effects of root canal irrigation and medication. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103: 560- 569.
20. http://www.dent.niigata-u.ac.jp/microbiol/ LSTR/background.html
21. Nakornchai S, Banditsing P, Visetratana N. Clinical evaluation of 3Mix and Vitapex® as treatment options for pulpally involved primary molars. Int J Pediatr Dent 2010; 20(3): 214-221.
22. Trairatvorakul C, Chunlasikaiwan S. Success of pulpectomy with zinc oxide-eugenol vs calcium hydroxide/iodoform paste in primary molars: a clinical stydy. Pediatr Dent 2008; 30(4): 303-308.
23. Ozalp N, Saroglu I, Sonmez H. Evaluation of various root canal filling materials in primary molar pulpectomies : An in vivo study. Am J Dent 2005; 28: 347-350.
24. Mortazavi M, Mesbahi M. Comparation of zinc oxide and eugenol and Vitapex for root canal treatment of necrotic primary teeth. Int J Pediatr Dent 2004; 14: 417-424.
25. Mani SA, Chawla HS, Tewari A, Foyal A. Evaluation of calcium hydroxide and zinc oxide eugenol as root canal filling materials in primary teeth. J Dent child 2000; 67: 142-147.
26. Detsomboonrat P. Success of three mix antibiotics in non-instrumentally endodontic treatment of primary molar [dissertation]. Bangkok: Chulalongkorn University; 2007 (in Thai)
27. Prabhakar AR, Sridevi E, Raju OS, Satishi V. Endodontic treatment of primary teeth using combination of antibacterial drugs: An in vivo study. J Indian Soc Pedod Prevent Dent 2008; S5-S10.
28. Sastararuji T, Trairatvorakul C. Succcess of calcium hydroxide indirect pulp treatment versus three mix antibiotics vital pulp therapy in lower primary molars. CU Dent J 2009; 32: 157-166. (in Thai)
29. Ketley CE, Goodman JR. Formocresol toxicity: is there a suitable alternative for pulpotomy of primary molars? Int J Pediatr Dent 1991; 2: 67-72.
30. Camp JH. Pulp therapy for primary and young permanent teeth. Dent Clin North Am 1984; 28: 651-668.