Eliminating microorganisms in the root canal system is important for the success of regenerative endodontics. Objective: This study evaluated the effects of different antibiotic pastes used for regenerative endodontic procedures on dentin microhardness and the push-out bond strength of mineral trioxide aggregate (MTA) to root canal dentin. Methods: Sixty-four maxillary central incisors were instrumented and randomly divided into the following four groups (n = 16) for medicament treatment: triple antibiotic paste, amoxicillin+clavulanic acid, cefaclor, and control (no dressing). After 21 days, two root segments were obtained by sectioning the roots horizontally for push-out and microhardness evaluations. MTA was placed into the root canal of the sectioned segment for the push-out test. In the microhardness evaluation, three indentations were made at 500 and 1,000 μm from the canal lumen. The arithmetic mean was then calculated for each distance. ANOVA with post hoc Scheffe test and t test were used for the statistical analyses. The significance level was set at p < 0.05. Results: No significant difference was found between the groups in terms of push-out bond strength (p > 0.05). Cefaclor and amoxicillin+clavulanic acid reduced the microhardness values of the dentin at 500 μm (p < 0.05) while cefaclor had the lowest value at 1,000 μm (p < 0.05). Conclusion: Cefaclor reduced the microhardness value more than the other medicaments did at a depth of 1,000 μm. The pastes provided similar adhesion of MTA.
1. Berkhoff JA, Chen PB, Teixeira FB, Diogenes A. Evaluation of triple antibiotic paste removal by different irrigation procedures. J Endod. 2014;40:1172-7.
2. Hargreaves KM, Diogenes A, Teixeira FB. Treatment options: biological basis of regenerative endodontic procedures. J Endod. 2013;39:S30-3.
3. Murray PE, Garcia-Godoy F, Hargreaves KM. Regenerative endodontics: a review of current status and a call for action. J Endod. 2007;33:377- 90.
4. Verma P, Nosrat A, Kim JR, Price JB, Wang P, Bair E, et al. Effect of residual bacteria on the outcome of pulp regeneration in vivo. J Dent Res. 2017;96:100-6.
5. Fouad AF. The microbial challenge to pulp regeneration. Adv Dent Res. 2011;23:285-9.
6. Sato T, Hoshino E, Uematsu H, Noda T. In vitro antimicrobial susceptibility to combinations of drugs on bacteria from carious and endodontic lesions of human deciduous teeth. Oral Microbiol Immunol. 1993;8:172-6.
7. Scarparo RK, Dondoni L, Bottcher DE, Grecca FS, Rockenbach MI, Batista EL Jr. Response to intracanal medication in immature teeth with pulp necrosis: an experimental model in rat molars. J Endod. 2011;37:1069-73.
8. Prather BT, Ehrlich Y, Spolnik K, Platt JA, Yassen GH. Effects of two combinations of triple antibiotic paste used in endodontic regeneration on root microhardness and chemical structure of radicular dentine. J Oral Sci. 2014;56:245-51.
9. Galler KM. Clinical procedures for revitalization: current knowledge and considerations. Int Endod J. 2016;49:926-36.
10. Keskin C, Guler DH, Sariyilmaz E. Effect of intracanal time of triple antibiotic paste on its removal from simulated immature roots using passive ultrasonic irrigation and XP-endo Finisher. J Dent Res Dent Clin Dent Prospects. 2018;12:288- 93.
11. Ruparel NB, Teixeira FB, Ferraz CC, Diogenes A. Direct effect of intracanal medicaments on survival of stem cells of the apical papilla. J Endod. 2012;38:1372-5.
12. AlSaeed T, Nosrat A, Melo MA, Wang P,Romberg E, Xu H, et al. Antibacterial efficacy and discoloration potential of endodontic topical antibiotics. J Endod. 2018;44:1110-4.
13. Yassen GH, Al-Angari SS, Platt JA. The use of traditional and novel techniques to determine the hardness and indentation properties of immature radicular dentin treated with antibiotic medicaments followed by ethylenediaminetetraacetic acid. Eur J Dent. 2014;8:521-7.
14. Yassen GH, Chu TM, Eckert G, Platt JA. Effect of medicaments used in endodontic regeneration technique on the chemical structure of human immature radicular dentin: an in vitro study. J Endod. 2013;39:269-73.
15. Chong BS, Pitt Ford TR. The role of intracanal medication in root canal treatment. Int Endod J. 1992;25:97-106.
16. Cruz-Filho AM, Sousa-Neto MD, Savioli RN, Silva RG, Vansan LP, Pecora JD. Effect of chelating solutions on the microhardness of root canal lumen dentin. J Endod. 2011;37:358-62.
17. Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J. 2018;51:284-317.
18. Jamshidi D, Homayouni H, Moradi Majd N, Shahabi S, Arvin A, Ranjbar Omidi B. Impact and fracture strength of simulated immature teeth treated with mineral trioxide aggregate apical plug and fiber post versus revascularization. J Endod. 2018;44:1878-82.
19. Galler KM, Krastl G, Simon S, Van Gorp G, Meschi N, Vahedi B, et al. European Society of Endodontology position statement: Revitalization procedures. Int Endod J. 2016;49:717-23.
20. Nagas E, Cehreli ZC, Durmaz V, Vallittu PK, Lassila LV. Regional push-out bond strength and coronal microleakage of Resilon after different light-curing methods. J Endod. 2007;33:1464-8.
21. Shahi S, Rahimi S, Yavari HR, Samiei M, Janani M, Bahari M, Lambrechts Pl. Effects of various mixing techniques on push-out bond strengths of white mineral trioxide aggregate. J Endod. 2012;38:501-4.
22. Yassen GH, Vail MM, Chu TG, Platt JA. The effect of medicaments used in endodontic regeneration on root fracture and microhardness of radicular dentine. Int Endod J. 2013;46:688-95.
23. Yassen GH, Eckert GJ, Platt JA. Effect of intracanal medicaments used in endodontic regeneration procedures on microhardness and chemical structure of dentin. Restor Dent Endod. 2015;40:104-12.
24. Zhang YR, Du W, Zhou XD, Yu HY. Review of research on the mechanical properties of the human tooth. Int J Oral Sci. 2014;6:61-9
25. Nagas E, Cehreli ZC, Uyanik MO, Vallittu PK, Lassila LV. Effect of several intracanal medicaments on the push-out bond strength of ProRoot MTA and Biodentine. Int Endod J. 2016;49:184-8.
26. Aydın MN, Buldur B. The effect of intracanal placement of various medicaments on the bond strength of three calcium silicate-based cements to root canal dentin. J Adhes Sci Technol. 2018;32:542-52.
27. Tasdemir T, Celik D, Er K, Yildirim T, Ceyhanli KT, Yesilyurt C. Efficacy of several techniques for the removal of calcium hydroxide medicament from root canals. Int Endod J. 2011;44:505-9.
28. Garcia-Godoy F, Murray PE. Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth. Dent Traumatol. 2012;28:33-41.
29. Topcuoglu HS, Arslan H, Akcay M, Saygili G, Cakici F, Topcuoglu G. The effect of medicaments used in endodontic regeneration technique on the dislocation resistance of mineral trioxide aggregate to root canal dentin. J Endod. 2014;40:2041-4.
30. Tulumbacı F, Almaz ME, Arıkan V, Mutluay MS. Evaluation of the push-out bond strength of ProRoot MTA and Bio-dentine after removal of calcium hydroxide and triple antibiotic paste. Int Dent Res. 2018;8:50-5.
31. Akman M, Akbulut MB, Güneşer MB, Eldeniz AÜ. Effect of intracanal medicaments on the pushout bond strength of Biodentine in comparison with Bioaggregate apical plugs. J Adhes Sci Technol. 2016;30:459-67.
Saricam, E., Bulak, N., Özyurt, E., & Özcan, S. Comparison of Medicaments Used in Regenerative Endodontics in Terms of Dentin Microhardness and Adhesion of Mineral Trioxide Aggregate. J Dent Indones. 2020;27(3): 114-119