Management of Deeply Carious Pulpally Involved Primary Teeth with Triple Antibiotic Paste – Review and Three Case Reports

Abstract

Root canal treatments are considered as one of the most important therapies in dentistry as they involve in maintaining and preserving the tooth along with its function up to a permissible extent. The root canal system exhibits different as well as complicated anatomical considerations. The necrotic pulp tissue remaining in the canal decreases the effects of root canal irrigants and medicaments and thereby will interfere with the proper and subsequent adaptation of root canal fillings to the dentinal surface. Taking these factors into account, modified disinfection and irrigation treatments are required to properly remove the leftover tissues from the root canal area, as well as to destroy the microorganisms there. Because odontogenic diseases harbour a large number of highly potent microorganisms, numerous treatment combinations, particularly antibiotics, are required to attack the microbiota responsible for the formation of these lesions. Over time as an adjunct to the conventional clinical procedures, antibiotics have begun to enlighten their prime significance. Several antibiotics have been investigated and used to control the dental infections. Triple antibiotic paste (TAP) containing metronidazole, ciprofloxacin and minocycline has been proposed as a root canal medicament due to its highly proven antimicrobial effects in endodontic regenerative procedures. However this combination had been modified in later years to reduce its associated side effects.