Review Article necessary and various intracanal medicaments have been tried. Intracanal medicaments, calcium hydroxide, antibiotics, corticosteroids. free root canal systems, especially in pulpless teeth, it is necessary to use intra- canal medicaments. These medicaments must be capable of destroying bacteria . Request PDF on ResearchGate | Antibiotics as intracanal medicaments: a review | Antibiotics are an extremely valuable addition to the armamentarium.

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Torabinejad M, Bahjri K. Scientifically based evidence that confirms the efficacy of intracanal medicaments on bacterial biofilm involves a profound reflection and discussion, regardless of the limits and caution rreview the methodology 16172136 Response to alkaline stress by root canal bacteria in biofilms.

From a total of 91 articles, 8. An in vitro comparison of the bactericidal efficacy of lethal photo – sensitization or sodium hyphochlorite irrigation on Streptococcus intermedius biofilms in root canals.

Study Selection The selected articles were identified from titles, abstracts and full-text articles by two independent reviewers, considering the tabulated inclusion and exclusion criteria.

Relevant clinical considerations are yet to be elucidated, such as the efficacy of intracanal medicament on bacterial medciaments, the time necessary for a mature endodontic biofilm to form or the ideal biofilm model to assess antimicrobial endodontic substances. Uncountable investigations 1 – 57912 – 1518202223262731 – 34383944 about the antimicrobial potential of intracanal medicaments on iintracanal biofilm have shown contradictory results, intarcanal the clinical question on how to eliminate the endodontic bacterial biofilm remains unclear.

Despite all known limitations, studies that are not developed in humans are also relevant because, prior to clearance for human use, biological evaluations of dental materials, initial and secondary tests are required Duggan and Sedgley 10 tested the hypothesis that the ability of E. The large number of published papers can bring in its context contradictory conclusions.

Thus, attached bacteria sessile growing in a biofilm display a wide range of characteristics that provide a number of advantages over single-cell planktonic bacteria. A major advantage is the protection that the biofilm provides to colonizing species from microorganisms competing for environmental factors, such as host defense mechanisms, and from potentially toxic substances in the environment, such as lethal chemicals or antibiotics.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Bacterial biofilm has an open architecture with channels traversing from the biofilm surface. However, the difficulty for comparing these studies was due to differences in the adopted treatment strategies, as follows: In this context, it is important to make a critical analysis of therapeutic protocols for the management of bacterial biofilm.

It is mandatory to consider the role and importance of biofilm in endodontics, as well as its definition. The results of the analysis demonstrated inefficacy of intracanal medicaments on bacterial biofilm. Autoaggregation and coaggregation of bacteria associated with acute endodontic infections.

Bacteria recovered from teeth with apical periodontitis after antimicrobial endodontic treatment. The selected articles were identified from titles, abstracts and full-text articles by two independent reviewers, considering the tabulated inclusion and exclusion criteria. Antimicrobial photodynamic therapy combined with conventional endodontic treatment to eliminate root canal biofilm infection.

Participation of bacterial biofilms in refractory and chronic periapical periodontitis. This structure affects the movement of molecules and gradients in key determinants develop. Author information Article notes Copyright medicwments License information Disclaimer.

None of the 8 articles referring to in vivo studies met all inclusion criteria Table 3. Invasion of dentinal tubules by root canal bacteria. EM evaluation of bacterial biofilm and microorganisms on the apical external root surface of human teeth.

Evidence-based dentistry involving systematic reviews or meta-analyses has been the ultimate goal to integrate the best available research evidence with clinical experience. Table 2 shows the inclusion and exclusion criteria for selection of the articles.

Antibiotics as intracanal medicaments: a review.

Law A, Messer H. The findings highlight the importance and need for stringently applying non-antibiotic chemomechanical measures in order to disrupt the biofilm and reduce the intraradicular microbial load to the lowest possible level to ensure the most favorable long-term prognosis for treatment of infected root canals. Several studies have been developed with different bacterial biofilm models to test the antimicrobial effectiveness of endodontic medicaments 19 – 111619242635 For the electronic search strategy the terms presented in Table 1 were used as keywords in several combinations.

A guide to interpreting discordant systematic reviews. Comparative evaluation of antimicrobial efficacy of sodium hypochlorite, MTAD, and Tetraclean against Enterococcus faecalis biofilm. The penetration of microorganisms in infected root dentin have shown variations considering the experimental model, the biological indicator and the time of incubation employed in the studies Table 4. Biofilm, Intracanal medicaments, Antimicrobial efficacy.



Prospective studies were reviewed with regard to the efficacy of the intracanal medicaments on medicamenfs biofilm. Support Center Support Center. Yag laser irradiation of the microbiological apical biofilm. Based on the inclusion and exclusion, 91 articles were selected, of which 17 Changes in the environment, such as calcium hydroxide-related pH increase or the effect of antimicrobials, are capable of triggering genetic cascades that modify the physiological characteristics of bacterial cells.

Susceptibilties of two Enterococcus faecalis phenotypes to root canal medications. Reduction of endodontic microbiota has been achieved by a series of antimicrobial strategies that include root canal preparation, irrigating solutions, intracanal dressing, and root canal filling.


The purpose of this paper is to make a critical analysis of the published research on the antibacterial efficacy of intracanal medicaments on bacterial biofilm. National Center for Biotechnology InformationU. The requirement for its development includes studies in human subjects with definite clinical issues, using a critical longitudinal analysis of published articles.

Antimicrobial efficacy of ozonated water, gaseous ozone, sodium hypochlorite and chlorhexidine in infected human root canals. Biofilms can also facilitate processing and uptake of nutrients, cross-feeding one species providing nutrients to anotherremoval of potentially harmful metabolic products often used by other bacteria as well as the development of an appropriate physicochemical environment such as a properly lowering the oxidation reduction potential.

Please review our privacy policy. However, the clinical effectiveness of these agents must be evaluated in the light of the complexity of root canal anatomy and polymicrobial nature of root canal infections.

The phases for the microbial community to develop a biofilm and colonize the environment may sometimes be unusual, but basically occur with the same sequence of developmental steps: How to write an evidence-based clinical review medicajents. Antibacterial effects of endodontic irrigants on black-pigmented Gram-negative anaerobes and facultative bacteria. Eur J Oral Sci.