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Research Article
Incorporation of amoxicillin-loaded microspheres in mineral trioxide aggregate cement: an in vitro study
Fábio Rocha Bohns, Vicente Castelo Branco Leitune, Isadora Martini Garcia, Bruna Genari, Nélio Bairros Dornelles, Silvia Stanisçuaski Guterres, Fabrício Aulo Ogliari, Mary Anne Sampaio de Melo, Fabrício Mezzomo Collares
Restor Dent Endod 2020;45(4):e50.   Published online October 7, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e50
AbstractAbstract PDFPubReaderePub
Objectives

In this study, we investigated the potential of amoxicillin-loaded polymeric microspheres to be delivered to tooth root infection sites via a bioactive reparative cement.

Materials and Methods

Amoxicillin-loaded microspheres were synthesized by a spray-dray method and incorporated at 2.5% and 5% into a mineral trioxide aggregate cement clinically used to induce a mineralized barrier at the root tip of young permanent teeth with incomplete root development and necrotic pulp. The formulations were modified in liquid:powder ratios and in composition by the microspheres. The optimized formulations were evaluated in vitro for physical and mechanical eligibility. The morphology of microspheres was observed under scanning electron microscopy.

Results

The optimized cement formulation containing microspheres at 5% exhibited a delayed-release response and maintained its fundamental functional properties. When mixed with amoxicillin-loaded microspheres, the setting times of both test materials significantly increased. The diametral tensile strength of cement containing microspheres at 5% was similar to control. However, phytic acid had no effect on this outcome (p > 0.05). When mixed with modified liquid:powder ratio, the setting time was significantly longer than that original liquid:powder ratio (p < 0.05).

Conclusions

Lack of optimal concentrations of antibiotics at anatomical sites of the dental tissues is a hallmark of recurrent endodontic infections. Therefore, targeting the controlled release of broad-spectrum antibiotics may improve the therapeutic outcomes of current treatments. Overall, these results indicate that the carry of amoxicillin by microspheres could provide an alternative strategy for the local delivery of antibiotics for the management of tooth infections.

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Case Report
Treatment of non-vital immature teeth with amoxicillin-containing triple antibiotic paste resulting in apexification
Hyon-Beom Park, Bin-Na Lee, Yun-Chan Hwang, In-Nam Hwang, Won-Mann Oh, Hoon-Sang Chang
Restor Dent Endod 2015;40(4):322-327.   Published online August 28, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.322
AbstractAbstract PDFPubReaderePub

A recent treatment option for non-vital immature teeth in young patients is revascularization with triple antibiotic paste (TAP). However, tooth discoloration was reported with the use of conventional minocycline-containing TAP. In this case report, amoxicillin-containing TAP was used for revascularization of non-vital immature teeth to prevent tooth discoloration. At the 1 yr follow up, the teeth were asymptomatic on clinical examination and showed slight discoloration of the crown due to mineral trioxide aggregate (MTA) filling rather than amoxicillin-containing TAP. Radiographic examination revealed complete resolution of the periapical radiolucency, and closed apex with obvious periodontal ligament space. However, the root growth was limited, and the treatment outcome was more like apexification rather than revascularization. These results may be due to unstable blood clot formation which could not resist the condensation force of MTA filling, whether or not a collagen matrix was in place. These cases showed that although revascularization was not successful, apexification could be expected, resulting in the resolution of the periapical radiolucency and the closure of the apex. Therefore, it is worthwhile attempting revascularization of non-vital immature teeth in young patients.

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