目的:已知三重抗生素糊剂(TAP)通过消除根管系统中的病原体,在成功进行牙髓治疗中具有重要作用。不幸的是,它在高浓度下引起变色和细胞毒性。本研究的目的是评估和比较各种浓度(1毫克,5毫克,10毫克)的TAP,TAP水凝胶(TAPH),M-TAP,和M-TAP水凝胶(MTAPH)对抗粪肠球菌。
方法:使用琼脂孔扩散法评估以下肛门内药物的抗生素敏感性:TAP(环丙沙星,甲硝唑,和米诺环素)以1:1:1的比例混合;TAPH,M-TAP(环丙沙星,甲硝唑,和阿莫西林),M-TAPH和普通水凝胶。对每种测试的药物分别评估其针对粪肠球菌的抗微生物活性。使用扫描电子显微镜(SEM)分析结构和形貌特征,并使用ImageJ软件进行解释。进行微量稀释液试验以检查M-TAP和TAP的最小抑制浓度和最小杀菌浓度(MBC)。
结果:除了普通水凝胶,M-TAP和水凝胶以及TAP和水凝胶在不同浓度下显示出明显不同的抑制区。与TAPH相比,M-TAPH在1、5和10mg/mL的浓度下显示出最高的平均抑制区,分别为21.6、33.33和38.0mm。显示出3.3毫米的平均抑制区,12.3mm,21.3毫米在各自的浓度。MIC研究表明,在5μg/mL浓度下,M-TAP抑制了75%以上的粪肠球菌生长,而TAP在浓度为35μg/mL时显示出抑制作用。MBC结果表明,TAP浓度为100μg/mL(10-1),M-TAP浓度为10μg/mL(10-2)时,几乎有99.9%的细菌种群被杀死。
结论:M-TAP的抗菌效果明显高于TAP。建议以较低剂量施用M-TAP以克服TAP所看到的缺点。
OBJECTIVE: Triple antibiotic paste (TAP) is known to have an essential role in the success of endodontic treatment by eliminating pathogens from the root canal system. Unfortunately, it causes discolouration and cytotoxicity at high concentrations. The objective of this research was to assess and compare the antimicrobial effectiveness of various concentrations (1 mg, 5 mg, 10 mg) of TAP, TAP hydrogel (TAPH), M-TAP, and M-TAP hydrogel (MTAPH) against Enterococcus faecalis.
METHODS: The agar well diffusion method was used to assess the antibiotic sensitivity of the following intracanal medicaments: TAP (ciprofloxacin, metronidazole, and minocycline) mixed in a ratio of 1: 1: 1; TAPH, M-TAP (ciprofloxacin, metronidazole, and amoxicillin), M-TAPH and plain hydrogel. Each tested medicament was individually evaluated for its antimicrobial activity against Enterococcus faecalis. Structural and topographical characterisation were analysed using a Scanning Electron Microscope (SEM) and interpreted using ImageJ software. A microdilution broth test was performed to examine the minimum inhibitory concentration and minimum bactericidal concentration (MBC) of M-TAP and TAP.
RESULTS: Except for the plain hydrogel, M-TAP and hydrogel and TAP and hydrogel showed significantly varied inhibitory zones at different concentrations. M-TAPH showed the highest mean zone of inhibition of 21.6, 33.33 and 38.0 mm at a concentration of 1, 5, and 10 mg/mL when compared to TAPH, which showed a mean zone of inhibition of 3.3 mm,12.3 mm, 21.3 mm at the respective concentrations. The MIC study shows that more than 75% of Enterococcus faecalis growth was inhibited by M-TAP at a concentration of 5 μg/mL, whereas TAP showed inhibition at a concentration of 35 μg/mL. MBC results indicate that almost 99.9% of the bacterial population was killed at a concentration of 100 μg/mL (10-1) for TAP and 10 μg/mL (10-2) for M-TAP.
CONCLUSIONS: The antibacterial efficacy of M-TAP was significantly higher than TAP. Application of M-TAP at lower doses is advised to overcome the disadvantages seen with TAP.