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Exploring the Potential of Nitrofurantoin for Infection Control in Regenerative Endodontics: In Vitro Study.

Fabiano Palmeira Gonçalves1, Olney Vieira-da-Motta2, Pantaleo Scelza Neto3

  • 1Postgraduate Program in Dentistry of Fluminense Federal University (UFF), Niteroi, Rio de Janeiro, Brazil.

Journal of Endodontics
|December 26, 2024
PubMed
Summary

A new nitrofurantoin-based antimicrobial paste effectively eradicated multispecies biofilms in root canals, showing superior results compared to conventional treatments. This formulation offers a promising alternative for regenerative endodontics.

Keywords:
Antibacterialsciprofloxacinmetronidazoleminocyclinenitrofurantoinregenerative endodontics

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Area of Science:

  • Microbiology
  • Endodontics
  • Dental Materials Science

Background:

  • Regenerative endodontics aims to preserve pulp vitality and restore tooth function.
  • Multispecies biofilms pose a significant challenge in endodontic treatment, often requiring effective antimicrobial strategies.
  • Conventional tri-antibiotic pastes have limitations in fully eradicating resistant microorganisms.

Purpose of the Study:

  • To evaluate a novel antimicrobial paste formulation containing nitrofurantoin for its efficacy against multispecies biofilms in regenerative endodontics.
  • To compare the performance of the nitrofurantoin-based paste with a conventional tri-antibiotic paste (Hoshino 1 and Hoshino 5 formulations).

Main Methods:

  • A polymicrobial biofilm (Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans) was established in root canals of extracted teeth.
  • Teeth were treated with either a negative control, Hoshino 1 paste, Hoshino 5 paste, or the experimental nitrofurantoin-ciprofloxacin-metronidazole paste.
  • Biofilm eradication was assessed using spectrophotometry, microbiological assays, plasma membrane permeabilization, confocal laser scanning microscopy, and scanning electron microscopy.

Main Results:

  • The experimental nitrofurantoin-based paste demonstrated significantly better performance than the negative control and Hoshino 1 paste (P < .05).
  • Its efficacy was comparable to the Hoshino 5 paste (P > .05).
  • Microscopic analyses revealed significantly reduced microorganisms and complete absence of residual biofilm in the experimental group.

Conclusions:

  • Replacing minocycline with nitrofurantoin in the antimicrobial paste formulation is effective in reducing microbial load in root canal systems.
  • The novel nitrofurantoin-containing paste shows significant potential for use in regenerative endodontics due to its potent antibiofilm activity.