Tooth discoloration of immature permanent incisor associated with triple antibiotic therapy: a case report.
BACKGROUND
A triple antibiotic mixture of ciprofloxacin, metronidazole, and minocycline was used as an intracanal medicament in an attempt to disinfect the root canal system for revascularization of a tooth with a necrotic pulp. However, discoloration developed after applying the triple antibiotic mixture.


METHODS
Six weeks after a triple antibiotic paste had been applied to the root canal of tooth #8 of a 7-year-old girl, the tooth showed a dark discoloration. An in vitro experiment with human extracted teeth was performed to determine which of the 3 antibiotics caused the tooth discoloration. Another experiment was then carried out to examine whether a currently used dentin bonding agent would prevent or reduce such discoloration. The degree of discoloration was assessed by using a colorimeter.


RESULTS
Among the components of the triple antibiotic paste, only minocycline caused the tooth discoloration. Moreover, the dentin bonding agent reduced the intensity of the discoloration but did not prevent it.


CONCLUSIONS
The possible esthetic problems with the tooth color should be considered when using minocycline as a canal medication.
Kim
Jong-Hyun
JH
Department of Conservative Dentistry, College of Dentistry, Yonsei University, Seoul, Korea.
Kim
Yuran
Y
Shin
Su-Jung
SJ
Park
Jeong-Won
JW
Jung
Il-Young
IY
D000180:Acrylic Resins / Q000737:chemistry; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002648:Child; D002939:Ciprofloxacin / Q000627:therapeutic use; D003124:Colorimetry; D019551:Dental Disinfectants / Q000009:adverse effects; D003790:Dental Pulp Necrosis / Q000188:drug therapy / Q000628:therapy; D017220:Dentin-Bonding Agents / Q000737:chemistry; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000187:drug effects*; D008795:Metronidazole / Q000627:therapeutic use; D008911:Minocycline / Q000009:adverse effects; D010485:Periapical Periodontitis / Q000188:drug therapy / Q000628:therapy; D012388:Root Canal Irrigants / Q000009:adverse effects*; D014073:Tooth Bleaching / Q000379:methods; D019228:Tooth Crown / Q000187:drug effects; D014075:Tooth Discoloration / Q000139:chemically induced* / Q000517:prevention & control
D000180:Acrylic Resins; C489662:AdheSE cement; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D019551:Dental Disinfectants; D017220:Dentin-Bonding Agents; D004338:Drug Combinations; D012388:Root Canal Irrigants; D008795:Metronidazole; D002939:Ciprofloxacin; D008911:Minocycline