Issues‎ > ‎vol8no2‎ > ‎


Evaluation of the Effect of Nitrofurantoin Paste as an Intracanal Medicament on the Chemical Structure of Radicular Dentine

Mewan S. Abdulrahman* , Bestoon M. Faraj* , Kawa F. Dizaye**
*Department of Conservative Dentistry, College of Dentistry, University of Sulaimani, Sulaimani, Iraq.
**Department of Basic Sciences, College of Medicine, Hawler Medical University, Erbil, Iraq.
Submitted: March 23, 2021, Accepted: June 6, 2021, Published: December 1, 2021.


Objective: To investigate the effects of a new intracanal medicament (nitrofurantoin paste) on radicular dentin's chemical structure compared with modified triple antibiotic paste (MTAP).  

MethodsA total of 9 extracted human maxillary canine teeth were used. After cutting the crowns, the root length was standardized to 15 mm. Three 5 mm root cylinders (coronal, middle, and apical) thirds were obtained. Each cylinder was then sectioned longitudinally across the root canal's maximum diameter, resulting in six half-root specimens; two coronal halves, two middle halves, and two apical halves. Then each specimen was divided into three groups. Group 1: 25mg/mL Nit paste, Group 2: 25mg/mL MTAP, and Group 3: (Untreated). Fourier transform infrared spectrophotometer (FTIR) with a diamond attenuated total reflectance (ATR) accessory was used to obtain infrared spectra to analyze dentin specimens. The data were analyzed statistically using one-way ANOVA and Tukey test, and significant differences were used for statistical analyses.     

ResultsDentin thirds treated with MTAP had a lower phosphate/amide I ratio (p < 0.05) than Nit paste compared with the untreated group. Moreover, the phosphate/amide I ratio was highest in the apical third and decreased to the lowest value in the coronal third. The differences among all three-thirds were statistically significant.

ConclusionsAccording to the current study results, at the concentration of (25 mg/mL), nitrofurantoin paste minimizes the reduction of phosphate/amide I ratio of the radicular dentine compared with the 25mg/mL MTAP.                                                                                     

Keywords:  Intracanal medicament, Chemical structure, Modified triple antibiotic paste, Nitrofurantoin.                                                                                                                                                                                                                                                Full Article - PDF           


1. Segura‐Egea J, Gould K, Şen BH, Jonasson P, Cotti E, Mazzoni A, et al. Antibiotics in Endodontics: a review. International endodontic journal. 2017;50(12):1169-84.
2. Rôças I, Siqueira J. Root canal microbiota of teeth with chronic apical periodontitis. Journal of clinical microbiology. 2008;46(11):3599-606.
3. Wang Q-Q, Zhang C-F, Chu C-H, Zhu X-F. Prevalence of Enterococcus faecalis in saliva and filled root canals of teeth associated with apical periodontitis. International Journal of oral science. 2012;4(1):19-23.
4. Siqueira Jr JF, Rôças IN. Polymerase chain reaction-based analysis of microorganisms associated with failed endodontic treatment. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2004;97(1):85-94.
5. Sedgley C, Nagel A, Dahlén G, Reit C, Molander A. Real-time quantitative polymerase chain reaction and culture analyses of Enterococcus faecalis in root canals. Journal of endodontics. 2006;32(3):173-7.
6. Gomes BP, Pinheiro ET, Jacinto RC, Zaia AA, Ferraz CC, Souza-Filho FJ. Microbial analysis of canals of root-filled teeth with periapical lesions using polymerase chain reaction. Journal of endodontics. 2008;34(5):537-40.
7. Karczewski A, Feitosa SA, Hamer EI, Pankajakshan D, Gregory RL, Spolnik KJ, et al. Clindamycin-modified triple antibiotic nanofibers: a stain-free antimicrobial intracanal drug delivery system. Journal of endodontics. 2018;44(1):155- 62.
8. AFTER TRIPLE ANTIBIOTIC PASTE USE, Kirchhoff A, Raldi D, Salles A, Cunha R, Mello I. Tooth discoloration, and internal bleaching. International Endodontic Journal. 2015;48(12):1181-7.
9. Jagdale S, Bhargava K, Bhosale S, Kumar T, Chawla M, Jagtap P. Comparative evaluation of coronal discoloration induced by two triple antibiotic revascularization protocols when used at varying depths of temporary sealing material at the end of varying time periods.
Journal of conservative dentistry: 2018;21(4):388-393.
10. Algarni AA, Yassen GH, Gregory RL. Inhibitory effect of gels loaded with a low concentration of antibiotics against biofilm formation by Enterococcus faecalis and Porphyromonas gingivalis. Journal of oral science. 2015;57(3):213-8.
11. Ravi K. Antimicrobial efficacy of various intracanal medicaments against Enterococcus faecalis. Journal of Pharmaceutical Sciences and Research. 2017;9(10):1861-3.
12. Ghabraei S, Marvi M, Bolhari B, Bagheri P. Minimum intracanal dressing time of triple antibiotic paste to eliminate Enterococcus faecalis (ATCC 29212) and determination of minimum inhibitory concentration and minimum bactericidal concentration: an ex vivo study.
Journal of Dentistry (Tehran, Iran). 2018;15(1):1-9.
13. Sabarathinam J, Muralidharan N. Antimicrobial efficacy of four different intracanal medicaments on contaminated extracted teeth: In vitro study. Drug Invention Today. 2018;10(2): 3026- 29.
14. Slots J. Selection of antimicrobial agents in periodontal therapy. Journal of periodontal research. 2002;37(5):389-98.
15. Huang GT-J. A paradigm shift in endodontic management of immature teeth: conservation of stem cells for regeneration. Journal of dentistry. 2008;36(6):379-86.
16. Cunha BA. Nitrofurantoin: an update. Obstetrical & gynecological survey. 1989;44(5):399-406.
17. Karam MRA, Habibi M, Bouzari S. Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli. Molecular immunology. 2019; 108:56-67.
18. Munoz-Davila MJ. Role of old antibiotics in the era of antibiotic resistance. Highlighted Nitrofurantoin for the treatment of lower urinary tract infections. Antibiotics. 2014;3(1):39-48.
19. Gardiner BJ, Stewardson AJ, Abbott IJ, Peleg AY. Nitrofurantoin and fosfomycin for resistant urinary tract infections: old drugs for emerging problems. Australian prescriber. 2019;42(1):14-19.
20. Abdulla FE, Abdulla EM. Antibiotic options for Enterococcus faecalis infection. Pakistan Journal of Medical Sciences. 2006;22(3):286-90. 21. Rahbar M, Hajia M, Farzanehkhah M. (2007). Activity of Nitrofurantoin Against Urinary Tract Infection (UTI) Isolates of
Vancomycin-Resistant Enterococci (VRE): A Three-Year Survey in an Iranian Hospital. Iranian Journal of Pathology; 2 (4):171 -4.
22. Toner L, Papa N, Aliyu SH, Dev H, Lawrentschuk N, Al-Hayek S. Vancomycin resistant enterococci in urine cultures: Antibiotic susceptibility trends over a decade at a tertiary hospital in the United Kingdom. Investigative and clinical urology. 2016 1;57(2):129-34.
23. Alrahman MSA, Faraj BM, Dizaye KF. Assessment of Nitrofurantoin as an Experimental Intracanal Medicament in Endodontics. Biomed Res Int. 2020; 2020:2128473.
24. Yassen GH, Eckert GJ, Platt JA. Effect of intracanal medicaments used in endodontic regeneration procedures on microhardness and chemical structure of dentin. Restorative dentistry & endodontics. 2015;40(2):104-12.
25. Eliades G. Clinical relevance of the formulation and testing of dentine bonding systems. Journal of dentistry. 1994;22(2):73-81.
26. Prather BT, Ehrlich Y, Spolnik K, Platt JA, Yassen GH. Effects of two combinations of triple antibiotic paste used in endodontic regeneration on root microhardness and chemical structure of radicular dentine. Journal of oral science. 2014;56(4):245-51.
27. Nerness A, Ehrlich Y, Spolnik K, Platt J, Yassen G. Effect of triple antibiotic paste with or without ethylenediaminetetraacetic acid on surface loss and surface roughness of radicular dentine. Odontology. 2016;104(2):170-5.
28. Alyas SM, Fischer BI, Ehrlich Y, Spolnik K, Gregory RL, Yassen GH. Direct and indirect antibacterial effects of various concentrations of triple antibiotic pastes loaded in a methylcellulose system. Journal of oral science. 2016;58(4):575- 82.
29. Elgendy AA, Nagy MM. The effect of different intracanal medications on fracture resistance of root canal dentin. Tanta Dental Journal. 2015 Sep 1;12(3):163-7.
30. Mewan A.Alrahman, Bestoon Muhammed Faraj, Dizaye KF. Evaluation of the biocompatibility of Nitrofurantoin as an experimental intracanal medicament in endodontics therapy. International Journal of Pharmaceutical Research. 2020;12(03):259-74.
31. Rosihan A, Widodo W, Bayu IS, Eko S. Effect pH on demineralization dental erosion. International Journal of Chemical Engineering and Applications. 2015;6(2):138-41.
32. Zhang K, Kim YK, Cadenaro M, Bryan TE, Sidow SJ, Loushine RJ, et al. Effects of different exposure times and concentrations of sodium hypochlorite/ethylenediaminetetraacetic acid on the structural integrity of mineralized dentin. Journal of endodontics. 2010 Jan 1;36(1):105-9.
33. Kara Tuncer A, Tuncer S, Siso SH. Effect of QMix irrigant on the microhardness of root canal dentine. Australian Dental Journal. 2015 Jun;60(2):163-8.
34. Parhizkar A, Nojehdehian H, Asgary S. Triple antibiotic paste: momentous roles and applications in endodontics: a review. Restor Dent Endod. 2018;43(3): e28.
35. Prather BT, Ehrlich Y, Spolnik K, Platt JA, Yassen GH. Effects of two combinations of triple antibiotic paste used in endodontic regeneration on root microhardness and chemical structure of radicular dentine. Journal of oral science. 2014;56(4):245-51.
36. Komabayashi T, Nonomura G, Watanabe LG, Marshall Jr GW, Marshall SJ. Dentin tubule numerical density variations below the CEJ. Journal of dentistry. 2008 Nov 1;36(11):953-8.
37. Pashley D, Okabe A, Parham P. The relationship between dentin microhardness and tubule density. Dental Traumatology. 1985 Oct;1(5):176-9.
38. Nikhil V, Jaiswal S, Bansal P, Arora R, Raj S, Malhotra P. Effect of phytic acid, ethylenediaminetetraacetic acid, and chitosan solutions on microhardness of the human radicular dentin. Journal of conservative dentistry: JCD. 2016 Mar;19(2):179-83.

Creative Commons License © The Authors, published by University of Sulaimani, College of Dentistry