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      Microbiological Profile of Primary Teeth with Irreversible Pulpitis and Pulp Necrosis with/without Abscess and their Susceptibility to Three Antibiotics as Intracanal Medication

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          A bstract

          Context

          The ineffective disinfection potential of conventional intracanal medicaments to eliminate enteropathogens from root canal systems leads to their persistence contributing to endodontic treatment failures. Hence, the use of appropriate intracanal medicament becomes the essential phase to accomplishing comprehensive decontamination of the root canal system. When applied topically as an intracanal medicament, antibiotics eradicate residual microorganisms from tortuous endodontic spaces, minimizing the risk of systemic toxicity.

          Aims and objectives

          To evaluate the prevalence of various bacterial species associated with signs of irreversible pulpitis and pulp necrosis with/without abscess in primary teeth root canals and their susceptibility against three antimicrobial agents.

          Materials and methods

          The pulp tissue and organic debris were retrieved from deciduous teeth ( n = 50) from children between the age of 3–10 years and cultured. The bacterial identification and antibacterial profiling of isolated bacteria were done against clindamycin, metronidazole, and doxycycline through minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assay. The MIC and MBC of each antibiotic were expressed as mean ± standard deviation (SD), range, and standard error (SE of the mean). The intergroup comparisons were done by the Kruskal–Wallis test, while intragroup pair-wise comparisons were done using the Wilcoxon signed-rank test. The confidence level will be set at 95%.

          Results

          Aerobic bacteria were found in 54%, microaerophilic bacteria in 76%, facultative anaerobes in 26%, and obligatory anaerobes were isolated from 30% of teeth. The intragroup and intergroup comparisons of test agent MIC revealed a nonsignificant difference ( p > 0.05). The intragroup MBC comparisons of all the test agents revealed statistically nonsignificant ( p > 0.05), while intergroup comparisons demonstrated nonsignificant ( p > 0.05) to highly significant difference ( p < 0.001).

          Conclusion

          Clindamycin demonstrated promising antibacterial activity against most of the isolated bacteria, while against metronidazole and doxycycline, most of the bacteria were moderate to highly resistant.

          Clinical significance

          Determining the antibacterial agents’ efficacy along with modifications can help to target maximum pathogenic microbes and reduce catastrophic endodontic therapy failures.

          How to cite this article

          Dahake PT, Kothari S. Microbiological Profile of Primary Teeth with Irreversible Pulpitis and Pulp Necrosis with/without Abscess and their Susceptibility to Three Antibiotics as Intracanal Medication. Int J Clin Pediatr Dent 2023;16(2):312-320.

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          Most cited references44

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          The estimation of the bactericidal power of the blood.

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            The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics.

            Bacteria have been implicated in the pathogenesis and progression of pulp and periapical diseases. The primary aim of endodontic treatment is to remove as many bacteria as possible from the root canal system and then to create an environment in which any remaining organisms cannot survive. This can only be achieved through the use of a combination of aseptic treatment techniques, chemomechanical preparation of the root canal, antimicrobial irrigating solutions and intracanal medicaments. The choice of which intracanal medicament to use is dependent on having an accurate diagnosis of the condition being treated, as well as a thorough knowledge of the type of organisms likely to be involved and their mechanisms of growth and survival. Since the disease is likely to have been caused by the presence of bacteria within the root canal, the use of an antimicrobial agent is essential. Many medicaments have been used in an attempt to achieve the above aims but no single preparation has been found to be completely predictable or effective. Commonly used medicaments include calcium hydroxide, antibiotics, non-phenolic biocides, phenolic biocides and iodine compounds. Each has advantages and disadvantages, and further research is required to determine which is best suited for root canal infections.
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              Antibiotic resistance of bacteria in biofilms.

              Bacteria that adhere to implanted medical devices or damaged tissue can encase themselves in a hydrated matrix of polysaccharide and protein, and form a slimy layer known as a biofilm. Antibiotic resistance of bacteria in the biofilm mode of growth contributes to the chronicity of infections such as those associated with implanted medical devices. The mechanisms of resistance in biofilms are different from the now familiar plasmids, transposons, and mutations that confer innate resistance to individual bacterial cells. In biofilms, resistance seems to depend on multicellular strategies. We summarise the features of biofilm infections, review emerging mechanisms of resistance, and discuss potential therapies.
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                Author and article information

                Journal
                Int J Clin Pediatr Dent
                Int J Clin Pediatr Dent
                IJCPD
                International Journal of Clinical Pediatric Dentistry
                Jaypee Brothers Medical Publishers
                0974-7052
                0975-1904
                Mar-Apr 2023
                : 16
                : 2
                : 312-320
                Affiliations
                [1 ]Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research (DMIHER) (Deemed to be University), Wardha, Maharashtra, India
                [2 ]Department of Pediatric Dentistry, Pacific Dental College & Research Center, Udaipur, Rajasthan, India
                Author notes
                Prasanna T Dahake, Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research (DMIHER) (Deemed to be University), Wardha, Maharashtra, India, Phone: +91 9096027989, e-mail: prasannadahake@ 123456gmail.com
                Article
                10.5005/jp-journals-10005-2521
                10373775
                8a9480da-f219-4177-bc94-d1eadfc259ec
                Copyright © 2023; The Author(s).

                © The Author(s). 2023 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                Categories
                Original Research

                antibacterial agents,dental pulp cavity,prevalence,pulpitis,tooth deciduous

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