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

This study assessed a new antimicrobial paste formulation containing nitrofurantoin for regenerative endodontics against multispecies biofilms.

Four groups of 11 single-root teeth each were tested: Negative control group (brain-heart infusion broth + micro-organisms); Hoshino 1 conventional tri-antibiotic paste group (1:1:1 ratio); Hoshino 5 group (5:5:5 ratio); Experimental group with nitrofurantoin, ciprofloxacin, and metronidazole. Minimum inhibitory concentrations of each antimicrobial were determined. A polymicrobial biofilm (Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans) was created in root canals, and pastes were inserted for 3 minutes with lentulo. After 7 days, samples were sonicated and spectrophotometrically analyzed. Microbiological assays, plasma membrane permeabilization, confocal laser scanning microscopy, and scanning electron microscopy evaluated biofilm eradication. Statistical significance was set at P < .05.

Spectrophotometry indicated Experimental group outperformed Hoshino 1 group and Negative control group (P < .05), with results similar to Hoshino 5 group (P > .05). Experimental group showed increased membrane damage compared to Hoshino 1 group and Hoshino 5 group. Confocal laser scanning microscopy and scanning electron microscopy revealed fewer microorganisms and no residual biofilm in Experimental group.

Substituting minocycline with nitrofurantoin in the paste effectively reduced microorganism counts in root canals system.