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HOME > Restor Dent Endod > Volume 37(2); 2012 > Article
Case Report Prevention of tooth discoloration associated with triple antibiotics
Bona Kim, DDS, Min-Ju Song, DDS, MS, Su-Jung Shin, DDS, PhD, Jeong-Won Park, DDS, PhD
2012;37(2):-122.
DOI: https://doi.org/10.5395/rde.2012.37.2.119
Published online: May 18, 2012

Department of Conservative Dentistry, Gangnam Severance Dental Hospital, Yonsei University College of Dentisty, Seoul, Korea.

Correspondence to Jeong-Won Park, DDS, PhD. Professor, Department of Conservative Dentistry, Yonsei University College of Dentistry, 712 Unjuro Dogok-dong Gangnam-gu, Seoul, Korea 135-720. TEL, +82-2-2019-1350; FAX, +82-2-3463-4052; pjw@yuhs.ac
• Received: December 29, 2011   • Revised: March 7, 2012   • Accepted: March 15, 2012

©Copyights 2012. The Korean Academy of Conservative Dentistry.

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  • Regenerative endodontics has a potential to heal a partially necrotic pulp, which can be beneficial for the continued root development and strengthening of immature teeth. For this purpose, triple antibiotic mixture of ciprofloxacin, metronidazole, and minocycline was recommended as intracanal medicament in an attempt to disinfect the root canal system for revascularization of a tooth with a necrotic pulp. However, discoloration of the tooth was reported after applying this. This case shows the idea for preventing the tooth discoloration using a delivery syringe (SW-O-01, Shinwoo dental) to avoid the contact between the clinical crown and the antibiotics.
  • Keywords: Delivery syringe; Discoloration; Minocycline; Regenerative endodontics; Triple antibiotics
Figure 1
Intraoral photographs. (a) Initial visit. Fracture of dens evaginatus was seen; (b) After triple antibiotics application; (c) 4 month follow-up after completion of the treatment. No discoloration was observed; (d) 1 year follow-up.
rde-37-119-g001.jpg
Figure 2
Periapical radiographs. (a) Initial visit. Periapical radiolucency and dens evaginatus was seen on #35; (b) After MTA filling and resin core;. (c) 4 month follow-up. Apical radiolucency was decreased and also the apical root growing is observed; (d) 8 month follow-up. Apical dentin was thickened and continuous lamina dura is observed; (e) 1 year follow-up. Apical bone regeneration was completed and apical closure is observed. MTA, mineral trioxide aggregate.
rde-37-119-g002.jpg
Figure 3
Metal tip delivery system filled with triple antibiotics. The rubber stop was used as a reference marker for applying the medicament under the clinical crown. The length of the needle was set 2 mm longer than the clinical crown.
rde-37-119-g003.jpg

No potential conflict of interest relevant to this article was reported.

Figure 1
Intraoral photographs. (a) Initial visit. Fracture of dens evaginatus was seen; (b) After triple antibiotics application; (c) 4 month follow-up after completion of the treatment. No discoloration was observed; (d) 1 year follow-up.
rde-37-119-g001.jpg
Figure 2
Periapical radiographs. (a) Initial visit. Periapical radiolucency and dens evaginatus was seen on #35; (b) After MTA filling and resin core;. (c) 4 month follow-up. Apical radiolucency was decreased and also the apical root growing is observed; (d) 8 month follow-up. Apical dentin was thickened and continuous lamina dura is observed; (e) 1 year follow-up. Apical bone regeneration was completed and apical closure is observed. MTA, mineral trioxide aggregate.
rde-37-119-g002.jpg
Figure 3
Metal tip delivery system filled with triple antibiotics. The rubber stop was used as a reference marker for applying the medicament under the clinical crown. The length of the needle was set 2 mm longer than the clinical crown.
rde-37-119-g003.jpg
  • 1. Jung IY, Lee SJ, Hargreaves KM. Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series. J Endod. 2008;34: 876-887.ArticlePubMed
  • 2. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod. 2004;30: 196-200.ArticlePubMed
  • 3. Huang GT. A paradigm shift in endodontic management of immature teeth: conservation of stem cells for regeneration. J Dent. 2008;36: 379-386.PubMed
  • 4. Windley W 3rd, Teixeira F, Levin L, Sigurdsson A, Trope M. Disinfection of immature teeth with a triple antibiotic paste. J Endod. 2005;31: 439-443.ArticlePubMed
  • 5. Cheek CC, Heymann HO. Dental and oral discolorations associated with minocycline and other tetracycline analogs. J Esthet Dent. 1999;11: 43-48.ArticlePubMed
  • 6. Dodd MA, Dole EJ, Troutman WG, Bennahum DA. Minocycline-associated tooth staining. Ann Pharmacother. 1998;32: 887-889.ArticlePubMedPDF
  • 7. McKenna BE, Lamey PJ, Kennedy JG, Bateson J. Minocycline-induced staining of the adult permanent dentition: a review of the literature and report of a case. Dent Update. 1999;26: 160-162.ArticlePubMed
  • 8. Petrino JA, Boda KK, Shambarger S, Bowles WR, McClanahan SB. Challenges in regenerative endodontics: a case series. J Endod. 2010;36: 536-541.ArticlePubMed
  • 9. Kim JH, Kim Y, Shin SJ, Park JW, Jung IY. Tooth discoloration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod. 2010;36: 1086-1091.ArticlePubMed
  • 10. Tanase S, Tsuchiya H, Yao J, Ohmoto S, Takagi N, Yoshida S. Reversed-phase ion-pair chromatographic analysis of tetracycline antibiotics. Application to discolored teeth. J Chromatogr B Biomed Sci Appl. 1998;706: 279-285.PubMed
  • 11. Hargreaves KM, Cohen S. Chapter 16, Regenerative endodontics. Cohen's pathways of the pulp expert consult. 2011;10th ed. St. Louis: Mosby Elsevier; 602-619.
  • 12. Reynolds K, Johnson JD, Cohenca N. Pulp revascularization of necrotic bilateral bicuspids using a modified novel technique to eliminate potential coronal discolouration: a case report. Int Endod J. 2009;42: 84-92.ArticlePubMed
  • 13. Sato I, Ando-Kurihara N, Kota K, Iwaku M, Hoshino E. Sterilization of infected root-canal dentine by topical application of a mixture of ciprofloxacin, metronidazole and minocycline in situ. Int Endod J. 1996;29: 118-124.ArticlePubMed

Tables & Figures

Figure 1
Intraoral photographs. (a) Initial visit. Fracture of dens evaginatus was seen; (b) After triple antibiotics application; (c) 4 month follow-up after completion of the treatment. No discoloration was observed; (d) 1 year follow-up.
rde-37-119-g001.jpg
Figure 2
Periapical radiographs. (a) Initial visit. Periapical radiolucency and dens evaginatus was seen on #35; (b) After MTA filling and resin core;. (c) 4 month follow-up. Apical radiolucency was decreased and also the apical root growing is observed; (d) 8 month follow-up. Apical dentin was thickened and continuous lamina dura is observed; (e) 1 year follow-up. Apical bone regeneration was completed and apical closure is observed. MTA, mineral trioxide aggregate.
rde-37-119-g002.jpg
Figure 3
Metal tip delivery system filled with triple antibiotics. The rubber stop was used as a reference marker for applying the medicament under the clinical crown. The length of the needle was set 2 mm longer than the clinical crown.
rde-37-119-g003.jpg
Figure 1
Intraoral photographs. (a) Initial visit. Fracture of dens evaginatus was seen; (b) After triple antibiotics application; (c) 4 month follow-up after completion of the treatment. No discoloration was observed; (d) 1 year follow-up.
rde-37-119-g001.jpg
Figure 2
Periapical radiographs. (a) Initial visit. Periapical radiolucency and dens evaginatus was seen on #35; (b) After MTA filling and resin core;. (c) 4 month follow-up. Apical radiolucency was decreased and also the apical root growing is observed; (d) 8 month follow-up. Apical dentin was thickened and continuous lamina dura is observed; (e) 1 year follow-up. Apical bone regeneration was completed and apical closure is observed. MTA, mineral trioxide aggregate.
rde-37-119-g002.jpg
Figure 3
Metal tip delivery system filled with triple antibiotics. The rubber stop was used as a reference marker for applying the medicament under the clinical crown. The length of the needle was set 2 mm longer than the clinical crown.
rde-37-119-g003.jpg

REFERENCES

  • 1. Jung IY, Lee SJ, Hargreaves KM. Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series. J Endod. 2008;34: 876-887.ArticlePubMed
  • 2. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod. 2004;30: 196-200.ArticlePubMed
  • 3. Huang GT. A paradigm shift in endodontic management of immature teeth: conservation of stem cells for regeneration. J Dent. 2008;36: 379-386.PubMed
  • 4. Windley W 3rd, Teixeira F, Levin L, Sigurdsson A, Trope M. Disinfection of immature teeth with a triple antibiotic paste. J Endod. 2005;31: 439-443.ArticlePubMed
  • 5. Cheek CC, Heymann HO. Dental and oral discolorations associated with minocycline and other tetracycline analogs. J Esthet Dent. 1999;11: 43-48.ArticlePubMed
  • 6. Dodd MA, Dole EJ, Troutman WG, Bennahum DA. Minocycline-associated tooth staining. Ann Pharmacother. 1998;32: 887-889.ArticlePubMedPDF
  • 7. McKenna BE, Lamey PJ, Kennedy JG, Bateson J. Minocycline-induced staining of the adult permanent dentition: a review of the literature and report of a case. Dent Update. 1999;26: 160-162.ArticlePubMed
  • 8. Petrino JA, Boda KK, Shambarger S, Bowles WR, McClanahan SB. Challenges in regenerative endodontics: a case series. J Endod. 2010;36: 536-541.ArticlePubMed
  • 9. Kim JH, Kim Y, Shin SJ, Park JW, Jung IY. Tooth discoloration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod. 2010;36: 1086-1091.ArticlePubMed
  • 10. Tanase S, Tsuchiya H, Yao J, Ohmoto S, Takagi N, Yoshida S. Reversed-phase ion-pair chromatographic analysis of tetracycline antibiotics. Application to discolored teeth. J Chromatogr B Biomed Sci Appl. 1998;706: 279-285.PubMed
  • 11. Hargreaves KM, Cohen S. Chapter 16, Regenerative endodontics. Cohen's pathways of the pulp expert consult. 2011;10th ed. St. Louis: Mosby Elsevier; 602-619.
  • 12. Reynolds K, Johnson JD, Cohenca N. Pulp revascularization of necrotic bilateral bicuspids using a modified novel technique to eliminate potential coronal discolouration: a case report. Int Endod J. 2009;42: 84-92.ArticlePubMed
  • 13. Sato I, Ando-Kurihara N, Kota K, Iwaku M, Hoshino E. Sterilization of infected root-canal dentine by topical application of a mixture of ciprofloxacin, metronidazole and minocycline in situ. Int Endod J. 1996;29: 118-124.ArticlePubMed

Citations

Citations to this article as recorded by  
  • Non-surgical Management of a Large Periapical Lesion: A Case Study of the Successful Application of a Modified Triple Antibacterial Paste
    Srushti Awghad, Joyeeta Mahapatra, Amit Reche, Ankita Burse, Aradhana Kibe
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  • Evaluation of the antimicrobial efficacy of two combinations of drugs on bacteria taken from infected primary teeth (in vitro)
    R. Rafatjou, R. Yousefimashouf, M. Farhadian, S. Afzalsoltani
    European Archives of Paediatric Dentistry.2019; 20(6): 609.     CrossRef
  • Triple antibiotic paste: momentous roles and applications in endodontics: a review
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    Restorative Dentistry & Endodontics.2018;[Epub]     CrossRef
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  • Revascularization of Necrotic Immature Permanent Teeth: An Update
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    Journal of Operative Dentistry & Endodontics.2016; 1(1): 18.     CrossRef
  • Treatment of non-vital immature teeth with amoxicillin-containing triple antibiotic paste resulting in apexification
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    Restorative Dentistry & Endodontics.2015; 40(4): 322.     CrossRef
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    Prevention of tooth discoloration associated with triple antibiotics
    Restor Dent Endod. 2012;37(2):119-122.   Published online May 18, 2012
    DOI: https://doi.org/10.5395/rde.2012.37.2.119
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Prevention of tooth discoloration associated with triple antibiotics
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Figure 1 Intraoral photographs. (a) Initial visit. Fracture of dens evaginatus was seen; (b) After triple antibiotics application; (c) 4 month follow-up after completion of the treatment. No discoloration was observed; (d) 1 year follow-up.
Figure 2 Periapical radiographs. (a) Initial visit. Periapical radiolucency and dens evaginatus was seen on #35; (b) After MTA filling and resin core;. (c) 4 month follow-up. Apical radiolucency was decreased and also the apical root growing is observed; (d) 8 month follow-up. Apical dentin was thickened and continuous lamina dura is observed; (e) 1 year follow-up. Apical bone regeneration was completed and apical closure is observed. MTA, mineral trioxide aggregate.
Figure 3 Metal tip delivery system filled with triple antibiotics. The rubber stop was used as a reference marker for applying the medicament under the clinical crown. The length of the needle was set 2 mm longer than the clinical crown.

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Prevention of tooth discoloration associated with triple antibiotics
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