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Title Tooth Discoloration Is A Risk Associated With Regenerative Endodontics
Clinical Question Is there a risk of tooth discoloration following regenerative endodontic treatment?
Clinical Bottom Line Case reports have shown some incidence of tooth discoloration following regenerative endodontic treatment. A controlled laboratory study has validated this finding by showing that the Minocycline, contained within the triple antibiotic paste, discolors the teeth similarly to the paste.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20478471Kim/201020 extracted maxillary & mandibular incisorsRandom controlled bench top study
Key resultsOnly the teeth exposed to Minocycline showed the same discoloration seen in the teeth exposed to triple antibiotic paste. It was also similar to the discoloration seen in the case report.
Evidence Search ("Minocycline"[Mesh]) AND "Tooth Discoloration"[Mesh]
Comments on
The Evidence
Groups were clearly defined with outcomes measured against the control group. Association makes biological sense since Minocyclin comes from the Tetracycline family which has been long proven to cause dark staining in the teeth.
Applicability This study was done on incisors that are important for the esthetic zone. The knowledge about possible tooth discoloration is critical when deciding to use this treatment. The clinician should avoid exposing any coronal dentin to the triple antibiotic paste. Some case reports have shown that using an adhesive on the chamber walls prior to TAP placement can minimize this risk.
Specialty/Discipline (Endodontics)
Keywords Regenerative Endodontics, Tooth Discoloration, Minocycline Staining
ID# 2086
Date of submission: 09/09/2011spacer
E-mail pratt@livemail.uthscsa.edu
Author Allen Pratt
Co-author(s) e-mail
Faculty mentor/Co-author Fabricio Teixeira, DDS, MS, PhD
Faculty mentor/Co-author e-mail fabricio-teixeira@uiowa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
Comments and Evidence-Based Updates on the CAT
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by Shanna Rafford, Analyssa Dominguez (San Antonio) on 11/28/2017
A PubMed search regarding tooth discoloration after endodontic therapy was performed in November 2017. A more recent systematic review supporting the conclusions of this CAT was found: Kahler 2016, (PMID 26852148) which indicates that the mineral trioxide aggregate can also be associated with discoloration. A second, more recent finding of a laboratory in vitro study, (Mandras, 2013; PMID 23755774) provides two alternative antibiotic combinations: 3-MIX C (clarithromycin) and 3-MIX F (fosfomycin). Both were shown to exhibit great antimicrobial activity without the permanent staining side effect. This evidence does not change the previously published answer to the clinical question, but it does provide alternative options for antimicrobials during regenerative endodontic treatment(s)

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