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Research Article
Discoloration of teeth due to different intracanal medicaments
Farzaneh Afkhami, Sadaf Elahy, Alireza Mahmoudi Nahavandi, Mohamad Javad Kharazifard, Aidin Sooratgar
Restor Dent Endod 2019;44(1):e10.   Published online February 12, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e10
AbstractAbstract PDFPubReaderePub
Objectives

The objective of this study was to assess coronal discoloration induced by the following intracanal medicaments: calcium hydroxide (CH), a mixture of CH paste and chlorhexidine gel (CH/CHX), and triple antibiotic paste (3Mix).

Materials and Methods

Seventy extracted single-canal teeth were selected. Access cavities were prepared and each canal was instrumented with a rotary ProTaper system. The specimens were randomly assigned to CH, CH/CHX, and 3Mix paste experimental groups (n = 20 each) or a control group (n = 10). Each experimental group was randomly divided into 2 subgroups (A and B). In subgroup A, medicaments were only applied to the root canals, while in subgroup B, the root canals were completely filled with medicaments and a cotton pellet dipped in medicament was also placed in the pulp chamber. Spectrophotometric readings were obtained from the mid-buccal surface of the tooth crowns immediately after placing the medicaments (T1) and at 1 week (T2), 1 month (T3), and 3 months (T4) after filling. The ∆E was then calculated. Data were analyzed using 2-way analysis of variance (ANOVA), 3-way ANOVA, and the Scheffé post hoc test.

Results

The greatest color change (ΔE) was observed at 3 months (p < 0.0001) and in 3Mix subgroup B (p = 0.0057). No significant color change occurred in the CH (p = 0.7865) or CH/CHX (p = 0.1367) groups over time, but the 3Mix group showed a significant ΔE (p = 0.0164).

Conclusion

Intracanal medicaments may induce tooth discoloration. Use of 3Mix must be short and it must be carefully applied only to the root canals; the access cavity should be thoroughly cleaned afterwards.

Citations

Citations to this article as recorded by  
  • Effects of Intra-canal Medicaments on Infrared Light Energy Transmission Through Enamel and Dentin During Photobiomodulation: An In Vitro Study
    Sachin Kulkarni, Laurence J. Walsh, Yash Bhurani, Roy George
    Journal of Endodontics.2025;[Epub]     CrossRef
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    Afsaneh Rahmati, Farshad Seyedein, Omid Dianat, Sara Saedi, Golriz Rostami, Alireza Akbarzadeh Baghban, Shima Sabertahan, Majid Kazem, Kee Y. Kum
    International Journal of Dentistry.2024;[Epub]     CrossRef
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    Leila Bassir, Shirin Taravati, Farzad Nouri, Saeide Rahimi
    Journal of Medicine and Life.2024; 17(5): 536.     CrossRef
  • In Vıtro Evaluatıon of Dıscoloratıon Caused by Root Canal Sealers and Color Changes after Bleachıng
    Emre Bodrumlu, Esma Dinger
    Annals of Dental Specialty.2024; 12(1): 77.     CrossRef
  • The effect of four different intracanal medicaments on the push-out bond strength of root canal sealers
    Shalu Maan, Vijaya Dhar Bhatt, Rohit Singh, Sayak Gupta, Syed Alay Noorain, Aashna Gill, Pradeep Kumar, Sushil Yadav, Preeti Sharma
    Journal of Medicine and Life.2022; 15(4): 448.     CrossRef
  • Effect of hydrogel-based antibiotic intracanal medicaments on crown discoloration
    Rayan B. Yaghmoor, Jeffrey A. Platt, Kenneth J. Spolnik, Tien Min Gabriel Chu, Ghaeth H. Yassen
    Restorative Dentistry & Endodontics.2021;[Epub]     CrossRef
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Review Article
Triple antibiotic paste: momentous roles and applications in endodontics: a review
Ardavan Parhizkar, Hanieh Nojehdehian, Saeed Asgary
Restor Dent Endod 2018;43(3):e28.   Published online June 20, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e28
AbstractAbstract PDFPubReaderePub

This study investigated the latest findings and notions regarding ‘triple antibiotic paste’ (TAP) and its applications in dentistry, particularly endodontics. TAP is a combination of 3 antibiotics, ciprofloxacin, metronidazole, and minocycline. Despite the problems and pitfalls research pertaining to this paste has unveiled, it has been vastly used in endodontic treatments. The paste's applications vary, from vital pulp therapy to the recently introduced regeneration and revascularisation protocol. Studies have shown that the paste can eliminate the root canal microorganisms and prepare an appropriate matrix for further treatments. This combination is able to remove diverse groups of obligate and facultative gram-positive and gram-negative bacteria, providing an environment for healing. In regeneration protocol cases, this allows the development, disinfection, and possible sterilization of the root canal system, so that new tissue can infiltrate and grow into the radicular area. Moreover, TAP is capable of creating a discipline in which other wanted and needed treatments can be successfully performed. In conclusion, TAP, as an antibacterial intracanal medication, has diverse uses. Nevertheless, despite its positive effects, the paste has shown drawbacks. Further research concerning the combined paste and other intracanal medications to control microbiota is a must.

Citations

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    Kiran Kumar N, Abhishek M, Savitha B. Naik, Biji Brigit, Swetha Geervani V, M Manimozhi
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    Dini Asrianti Bagio, Ibramanto Warganegara, Ike Dwi Maharti, Anggraini Margono, Citra Kusumasari, Sylva Dinie Alinda, Valeria Widita Wairooy
    European Journal of General Dentistry.2025; 14(01): 073.     CrossRef
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    Divya Singh, Rashi Singh, Nidhi Gupta, Natasha Gambhir, Saritha Golla
    International Journal of Clinical Pediatric Dentistry.2024; 17(3): 285.     CrossRef
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    Arokia Rajkumar Shancy Merlin, Vignesh Ravindran, Ganesh Jeevanandan, Rajalakshmanan Eswaramoorthy, Abirami Arthanari
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    Khalifah A. Alhaila, Manal Farouk Badawi, Mohamed G. Elbeltagy, Amany E. Badr
    European Journal of General Dentistry.2024; 13(01): 051.     CrossRef
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    Paúl Sebastián Ulloa Amores, Diana Álvarez Álvarez, María Elizabeth Moscoso Abad, Magda Zulay Bastidas Calva
    Revista de la Asociación Dental Mexicana.2024; 81(4): 211.     CrossRef
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    Kalagi G. Panchal, Karima Virani, Vraj Patel, Aquib Ali Khan, Anam Pettiwala, Srikala S. Puranik, Srushti Joshi
    Journal of Pharmacy and Bioallied Sciences.2024; 16(Suppl 3): S1913.     CrossRef
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  • Adjunctive antimicrobial photodynamic therapy to conventional chemo-mechanical debridement of infected root canal systems: A systematic review and meta-analysis
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  • Comparison of Antibacterial Effects of Photodynamic Therapy, Modified Triple Antibiotic Paste and Calcium Hydroxide on Root Canals Infected With Enterococcus faecalis: An In Vitro Study
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  • 60 Crossref
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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.

Citations

Citations to this article as recorded by  
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    Sadhna Sharma, Urvashi Bhushan, Mridula Goswami, CP Baveja
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    Justyna Zbańska, Katarzyna Herman, Piotr Kuropka, Maciej Dobrzyński
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Research Article
Effect of intracanal medicaments used in endodontic regeneration procedures on microhardness and chemical structure of dentin
Ghaeth Hamdon Yassen, George Joseph Eckert, Jeffrey Allen Platt
Restor Dent Endod 2015;40(2):104-112.   Published online December 24, 2014
DOI: https://doi.org/10.5395/rde.2015.40.2.104
AbstractAbstract PDFPubReaderePub
Objectives

This study was performed to investigate the effects of different intracanal medicaments on chemical structure and microhardness of dentin.

Materials and Methods

Fifty human dentin discs were obtained from intact third molars and randomly assigned into two control groups and three treatment groups. The first control group received no treatment. The second control group (no medicament group) was irrigated with sodium hypochlorite (NaOCl), stored in humid environment for four weeks and then irrigated with ethylenediaminetetraacetic acid (EDTA). The three treatment groups were irrigated with NaOCl, treated for four weeks with either 1 g/mL triple antibiotic paste (TAP), 1 mg/mL methylcellulose-based triple antibiotic paste (DTAP), or calcium hydroxide [Ca(OH)2] and finally irrigated with EDTA. After treatment, one half of each dentin disc was subjected to Vickers microhardness (n = 10 per group) and the other half was used to evaluate the chemical structure (phosphate/amide I ratio) of treated dentin utilizing attenuated total reflection Fourier transform infrared spectroscopy (n = 5 per group). One-way ANOVA followed by Fisher's least significant difference were used for statistical analyses.

Results

Dentin discs treated with different intracanal medicaments and those treated with NaOCl + EDTA showed significant reduction in microhardness (p < 0.0001) and phosphate/amide I ratio (p < 0.05) compared to no treatment control dentin. Furthermore, dentin discs treated with TAP had significantly lower microhardness (p < 0.0001) and phosphate/amide I ratio (p < 0.0001) compared to all other groups.

Conclusions

The use of DTAP or Ca(OH)2 medicaments during endodontic regeneration may cause significantly less microhardness reduction and superficial demineralization of dentin compared to the use of TAP.

Citations

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