Abstract
Objectives This study aimed to evaluate the cytotoxicity of minimum antibacterial values of
medicaments used in endodontic regeneration on stem cells.
Materials and Methods “Minimum inhibitory concentration,” “minimum bactericidal concentration,” and “minimum
biofilm inhibitory concentration” of triple and double antibiotic paste, a modified
triple antibiotic paste (minocycline replaced by clindamycin), Augmentin, and calcium
hydroxide were determined using Enterococcus faecalis (ATCC 29212) by microtiter plate method. Direct cytotoxic effects of drugs were evaluated
by lactate dehydrogenase and water-soluble tetrazolium salt-1 assays using stem cells
of apical papilla obtained from immature third molars via enzymatic digestion.
Statistical Analysis Data were analyzed using IBM SPSS Statistics 24, one-way analysis of variance and
post hoc comparisons. The statistical power was set at p < 0.05.
Results All medicaments caused similar cytotoxicity and cell proliferation at “minimum inhibitory
concentration” (p > 0.05) except Augmentin which was significantly more toxic than others (p < 0.05). At “minimum bactericidal concentration,” calcium hydroxide was more toxic
than other drugs (p < 0.001), but its adverse effect on cell proliferation was the same as Augmentin
(p > 0.05). Triple and double antibiotic paste revealed similar favorable effects in
terms of toxicity and proliferation rate at most of the tested concentrations (p > 0.05). At “minimum biofilm inhibitory concentration” both the modified paste and
Augmentin caused less proliferation rate than triple and double antibiotic paste (p < 0.001and p < 0.05, respectively) and Augmentin induced more cytotoxicity (p < 0.05).
Conclusions Considering the antimicrobial potency, triple antibiotic paste seems to be the safest
drug for the stem cells of apical papilla, while Augmentin may have some adverse effects.
Keywords
antibiotics - regenerative endodontics - stem cells - toxicity
