Antibacterial effectiveness of diluted preparations of intracanal medicaments used in regenerative endodontic treatment on dentin infected by bacterial biofilm: An ex vivo investigation

Abstract

Background: Conventional drug mixtures used in regenerative endodontic procedures have a toxic effect and no consensus has been reached about their best composition and concentration. Therefore, the aim of this study was to determine minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and minimum biofilm inhibitory concentration (MBIC) of the antimicrobial preparations and to compare their antimicrobial efficacy on bovine dentin infected by Enterococcus faecalis. Materials and Methods: For this original ex vivo investigation, prepared concentrations (MIC, MBC, and MBIC) of triple antibiotic paste (TAP), double antibiotic paste (DAP), modified triple antibiotic paste (MTAP)-1, MTAP2, co-amoxiclav, and calcium hydroxide (CH) were added to the prepared bovine dentin blocks (which incubated in E. faecalis suspension previously) and incubated for 3 days. The samples were subsequently prepared for culture and CFU counts. Statistical analysis of data was carried out using one-way analysis of variance and post hoc tests. The statistical power was set at P < 0.05. Results: All medicament groups significantly showed an antimicrobial efficacy compared with negative control (without antibiotic) (P < 0.001). TAP, DAP, co-amoxiclav, and CH (at its MBC value) were significantly capable of eliminating E. faecalis biofilm and showed no significant difference in comparison with positive control (complete biofilm removal) (P < 0.05). Conclusion: TAP, DAP, co-amoxiclav, and CH (at its MBC value) could effectively eliminate biofilm bacteria on the dentin surface. Antimicrobial efficacy of other medicaments containing cefaclor or clindamycin was limited.