title: Microbial evaluation of traumatized teeth treated with triple antibiotic paste or calcium hydroxide with 2% chlorhexidine gel in pulp revascularization.
abstract: BACKGROUND
  Revascularization outcome depends on microbial elimination because apical repair will not happen in the presence of infected tissues. This study evaluated the microbial composition of traumatized immature teeth and assessed their reduction during different stages of the revascularization procedures performed with 2 intracanal medicaments.
  
  
  METHODS
  Fifteen patients (7-17 years old) with immature teeth were submitted to the revascularization procedures; they were divided into 2 groups according to the intracanal medicament used: TAP group (n = 7), medicated with a triple antibiotic paste, and CHP group (n = 8), dressed with calcium hydroxide + 2% chlorhexidine gel. Samples were taken before any treatment (S1), after irrigation with 6% NaOCl (S2), after irrigation with 2% chlorhexidine (S3), after intracanal dressing (S4), and after 17% EDTA irrigation (S5). Cultivable bacteria recovered from the 5 stages were counted and identified by means of polymerase chain reaction assay (16S rRNA).
  
  
  RESULTS
  Both groups had colony-forming unit counts significantly reduced after S2 (P < .05); however, no significant difference was found between the irrigants (S2 and S3, P = .99). No difference in bacteria counts was found between the intracanal medicaments used (P = .95). The most prevalent bacteria detected were Actinomyces naeslundii (66.67%), followed by Porphyromonas endodontalis, Parvimonas micra, and Fusobacterium nucleatum, which were detected in 33.34% of the root canals. An average of 2.13 species per canal was found, and no statistical correlation was observed between bacterial species and clinical/radiographic features.
  
  
  CONCLUSIONS
  The microbial profile of infected immature teeth is similar to that of primarily infected permanent teeth. The greatest bacterial reduction was promoted by the irrigation solutions. The revascularization protocols that used the tested intracanal medicaments were efficient in reducing viable bacteria in necrotic immature teeth.
authors.affiliation: Department of Restorative Dentistry, Endodontics Division, State University of Campinas-UNICAMP, Piracicaba, São Paulo, Brazil.
authors.forename: Juliana Y
authors.initials: JY
authors.lastname: Nagata
authors.affiliation: Department of Restorative Dentistry, Endodontics Division, State University of Campinas-UNICAMP, Piracicaba, São Paulo, Brazil.
authors.forename: Adriana J
authors.initials: AJ
authors.lastname: Soares
authors.affiliation: Department of Restorative Dentistry, Endodontics Division, State University of Campinas-UNICAMP, Piracicaba, São Paulo, Brazil.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Souza-Filho
authors.affiliation: Department of Restorative Dentistry, Endodontics Division, State University of Campinas-UNICAMP, Piracicaba, São Paulo, Brazil.
authors.forename: Alexandre A
authors.initials: AA
authors.lastname: Zaia
authors.affiliation: Department of Restorative Dentistry, Endodontics Division, State University of Campinas-UNICAMP, Piracicaba, São Paulo, Brazil.
authors.forename: Caio C R
authors.initials: CC
authors.lastname: Ferraz
authors.affiliation: Department of Restorative Dentistry, Endodontics Division, State University of Campinas-UNICAMP, Piracicaba, São Paulo, Brazil.
authors.forename: José F A
authors.initials: JF
authors.lastname: Almeida
authors.affiliation: Department of Restorative Dentistry, Endodontics Division, State University of Campinas-UNICAMP, Piracicaba, São Paulo, Brazil. Electronic address: bpgomes@fop.unicamp.br.
authors.forename: Brenda P F A
authors.initials: BP
authors.lastname: Gomes
mesh_terms: D000190:Actinomyces / Q000187:drug effects / Q000302:isolation & purification; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D056624:Apexification / Q000379:methods*; D058491:Bacterial Load / Q000187:drug effects; D002126:Calcium Hydroxide / Q000627:therapeutic use*; D002648:Child; D002710:Chlorhexidine / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use; D003786:Dental Pulp Cavity / Q000187:drug effects / Q000382:microbiology*; D003790:Dental Pulp Necrosis / Q000382:microbiology / Q000628:therapy; D004492:Edetic Acid / Q000627:therapeutic use; D016967:Fusobacterium nucleatum / Q000187:drug effects / Q000302:isolation & purification; D005782:Gels; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D050296:Microbial Viability / Q000187:drug effects; D008911:Minocycline / Q000627:therapeutic use; D010462:Peptostreptococcus / Q000187:drug effects / Q000302:isolation & purification; D045202:Porphyromonas endodontalis / Q000187:drug effects / Q000302:isolation & purification; D012388:Root Canal Irrigants / Q000627:therapeutic use*; D012973:Sodium Hypochlorite / Q000627:therapeutic use; D019227:Tooth Apex / Q000187:drug effects / Q000382:microbiology; D018677:Tooth Injuries / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D005782:Gels; D012388:Root Canal Irrigants; D008795:Metronidazole; D002939:Ciprofloxacin; D004492:Edetic Acid; D012973:Sodium Hypochlorite; D008911:Minocycline; D002126:Calcium Hydroxide; D002710:Chlorhexidine
keywords: Antibiotic paste; calcium hydroxide; chlorhexidine; endodontics; microorganisms; polymerase chain reaction; pulp revascularization