Exploring non-antimicrobial agents as antibiotic alternatives: an in vitro study


Main Article Content

Aswini Nuka
Roopesh Borugadda
U Lavanya Neelima
Aishwarya Manchem
V Solomon Prabhu
Sahith Dasari

Abstract

Background: Microorganisms cause periapical and pulpal disorders, making root canal treatment (RCT) essential. Due to complex canal anatomy, bacteria may persist despite cleaning. Intracanal medicaments, such as calcium hydroxide and chlorhexidine, help eliminate residual bacteria, reduce inflammation, and enhance treatment outcomes by improving disinfection and compatibility.


Aim: To assess the antimicrobial effectiveness of Triple Antibiotic Paste (TAP), Modified TAP, Sertraline (SSRI), Atorvastatin and the combination of Atorvastatin and Sertraline against Enterococcus faecalis.


Materials and methods: A total of 30 samples were made, with 6 samples from each group: TAP, Sertraline, Atorvastatin, Modified TAP, and Sertraline + Atorvastatin. The antimicrobial efficacy of the medicaments was evaluated using an agar well diffusion test by measuring inhibition zones around the medicaments. Statistical analysis included one-way ANOVA, with significance set at p < 0.05.


Results: A significant difference (p=0.001) in the diameter of growth inhibition zones was observed. The maximum inhibitory zone was found in Group 5: Sertraline+Atorvastatin.


Conclusion: The combination of sertraline and atorvastatin demonstrated superior antimicrobial efficacy compared to modified TAP, TAP, sertraline, and atorvastatin used alone.

Article Details


How to Cite
Nuka, A., Borugadda, R., Neelima, U. L., Manchem, A., Prabhu , V. S., & Dasari, S. (2024). Exploring non-antimicrobial agents as antibiotic alternatives: an in vitro study. International Journal of Dental Materials, 6(4), 99–103. https://doi.org/10.37983/IJDM.2024.6404
Author Biographies

Aswini Nuka, GSL Dental College and Hospital

Postgraduate Student, Department of Conservative Dentistry and Endodontics, GSL Dental College and Hospital, Rajahmundry, Andhra Pradesh, India.

Roopesh Borugadda, GSL Dental College and Hospital

Professor and Head, Department of Conservative Dentistry and Endodontics, GSL Dental college and Hospital, Rajahmundry, Andhra Pradesh, India.

U Lavanya Neelima, GSL Dental College and Hospital

Associate Professor, Department of Conservative Dentistry and Endodontics, GSL Dental College and Hospital, Rajahmundry, Andhra Pradesh, India.

Aishwarya Manchem, GSL Dental College and Hospital

Postgraduate Student, Department of Conservative Dentistry and Endodontics, GSL Dental College and Hospital, Rajahmundry, Andhra Pradesh, India.

V Solomon Prabhu , GSL Dental College and Hospital

Postgraduate Student, Department of Conservative Dentistry and Endodontics, GSL Dental College and Hospital, Rajahmundry, Andhra Pradesh, India.

Sahith Dasari, GSL Dental College and Hospital

Postgraduate Student, Department of Conservative Dentistry and Endodontics, GSL Dental College and Hospital, Rajahmundry, Andhra Pradesh, India.

References

  1. Tilokani A, Agrawal P, Pradhan PK, Patri G, Karmakar N, Sinha Y. Comparative evaluation of antibacterial efficacy of nonsteroidal anti-inflammatory medications and proton-pump inhibitor against Enterococcus faecalis: An in vitro study. J Conserv Dent. 2023;26(1):79-82. https://doi.org/10.4103/jcd.jcd_419_22
  2. Chong BS, Pitt Ford TR. The role of intracanal medication in root canal treatment. Int Endod J. 1992;25(2):97 106. https://doi.org/10.1111/j.1365-2591.1992.tb00743.x
  3. Distel JW, Hatton JF, Gillespie MJ. Biofilm formation in medicated root canals. J Endod. 2002;28(10):689 93. https://doi.org/10.1097/00004770-200210000-00003
  4. Momenijavid M, Salimizand H, Korani A, Dianat O, Nouri B, Ramazanzadeh R, et al. Effect of calcium hydroxide on morphology and physicochemical properties of Enterococcus faecalis biofilm. Scientific Rep. 2022;12(1):7595. https://doi.org/10.1038/s41598-022-11780-x
  5. Zargar N, Rayat Hosein Abadi M, Sabeti M, Yadegari Z, Akbarzadeh Baghban A, Dianat O. Antimicrobial efficacy of clindamycin and triple antibiotic paste as root canal medicaments on tubular infection: An in vitro study. Aust Endod J. 2019;45(1):86 91. https://doi.org/10.1111/aej.12288
  6. Ghabraei S, Bolhari B, Sabbagh MM, Afshar MS. Comparison of antimicrobial effects of triple antibiotic paste and calcium hydroxide mixed with 2% chlorhexidine as intracanal medicaments against Enterococcus faecalis biofilm. J Dent (Tehran). 2018;15(3):151 60.
  7. Barbarossa A, Rosato A, Corbo F, Clodoveo ML, Fracchiolla G, Carrieri A, et al. Non Antibiotic drug repositioning as an alternative antimicrobial approach. Antibiotics (Basel). 2022;11(6):816. https://doi.org/10.3390/antibiotics11060816
  8. Ayaz M, Subhan F, Ahmed J, Khan AU, Ullah F, Ullah I, Ali G, Syed NI, Hussain S. Sertraline enhances the activity of antimicrobial agents against pathogens of clinical relevance. J Biol Res-Thessaloniki. 2015;22:1-8. https://doi.org/10.1186/s40709-015-0028-1
  9. Salem Milani A, Balaei Gajan E, Rahimi S, Moosavi Z, Abdollahi A, Zakeri Milani P, et al. Antibacterial effect of diclofenac sodium on Enterococcus faecalis. J Dent (Tehran). 2013;10(1):16 22.
  10. Haapasalo M, Orstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res. 1987;66(8):1375 9. https://doi.org/10.1177/00220345870660081801
  11. Kontakiotis EG, Filippatos CG, Tzanetakis GN, Agrafioti A. Regenerative endodontic therapy: A data analysis of clinical protocols. J Endod. 2015;41(2):146 54. https://doi.org/10.1016/j.joen.2014.08.003
  12. Chandwani ND, Maurya N, Nikhade P, Chandwani J. Comparative evaluation of antimicrobial efficacy of calcium hydroxide, triple antibiotic paste and bromelain against Enterococcus faecalis: An In Vitro study. J Conserv Dent 2022;25(1):63 7. https://doi.org/10.4103/jcd.jcd_461_21
  13. Ferreira MB, Myiagi S, Nogales CG, Campos MS, Lage Marques JL. Time and concentration dependent cytotoxicity of antibiotics used in endodontic therapy. J Appl Oral Sci 2010;18:259 63. https://doi.org/10.1590/S1678-77572010000300011
  14. Sato T, Hoshino E, Uematsu H, et al. Bactericidal efficacy of a mixture of ciprofloxacin, metronidazole, minocycline and rifampicin against bacteria of carious and endodontic lesions of human deciduous teeth in vitro. MicrobEcol Health Dis. 1992;5(4):171–177. https://doi.org/10.3109/08910609209141583
  15. Mohammadi Z, Abbott PV. On the local applications of antibiotics and antibiotic?based agents in endodontics and dental traumatology. Int EndodJourn. 2009;42(7):555–567. https://doi.org/10.1111/j.1365-2591.2009.01564.x
  16. Karczewski A, Feitosa SA, Hamer EI, et al. Clindamycin-modified triple antibiotic nanofibers: a stain-free antimicrobial intracanal drug delivery system. J Endod. 2018;44(1):155–162. https://doi.org/10.1016/j.joen.2017.08.024