Endodontic drug delivery for root surface disinfection: a laboratory feasibility evaluation

Area of Science:

• Endodontics
• Microbiology
• Periodontology

Background:

• Perio-endo lesions present complex challenges requiring effective antimicrobial strategies.
• Disinfection of the outer root surface is crucial for managing these lesions.
• Novel intracanal dressings are needed to address persistent bacterial challenges.

Purpose of the Study:

• To evaluate the efficacy of TreVitaMix (TVM), a novel antibiotic mixture, as an intracanal dressing.
• To assess TVM's potential to disinfect the outer root surface in an in vitro model.
• To determine the duration of antimicrobial activity of TVM against Fusobacterium nucleatum.

Main Methods:

• Bovine roots underwent endodontic treatment and were exposed to different intracanal medications: sterile saline, propylene glycol, TVM, and calcium hydroxide.
• A novel in vitro model was used, involving inoculation with Fusobacterium nucleatum and incubation up to 192 hours.
• Inhibition zones around the roots were measured to assess antimicrobial activity, with and without cementum presence.

Main Results:

• TVM demonstrated significant inhibition of Fusobacterium nucleatum growth at all measured time points.
• Control groups (saline, propylene glycol) and calcium hydroxide showed no significant peri-radicular inhibition.
• The presence of cementum did not negatively impact TVM's disinfection efficacy.

Conclusions:

• TVM effectively penetrates dentin and inhibits bacterial growth of Fusobacterium nucleatum for up to 192 hours.
• TVM shows potential as a sustained disinfectant for the outer root surface in perio-endo lesions.
• TVM may serve as an effective adjunctive antimicrobial agent in endodontic and periodontal treatments.