ABSTRACT
Regenerative endodontics has become a revolutionizing tissue engineering concept in the treatment of immature permanent teeth for over two decades. It has been described as a ‘paradigm shift’ in the treatment of immature teeth, since it fosters continued root maturation. An immature necrotic permanent tooth is usually a result of trauma or infection due to which the tooth becomes non-vital before completing root development. In such cases, the root walls are left thin and weak with an open apex. Traditional apexification procedures may resolve pathology but have not been able to prove tooth survival due to absence of continued root development and risk of root fracture. A successful regenerative endodontic procedure (REP) results in resolution of signs and symptoms of pathology, radiographic signs of healing, proof of continued root development as well as presence of pulp vitality due to the regeneration of pulp tissue in the root canal. Various stem cells, growth factors, scaffolds and suitable environment form the tetrad of elements necessary to induce regeneration of dental pulp. While there has been some success in isolating dental pulp cells with in-vitroexperiments, it has been proven to be rather difficultto implement the same in a practical perspective ex vivo. Although there has been clinical success related to REP, histologically they seem to undergo guided endodontic repair rather than true regeneration of physiologic pulp tissue. This review provides an overview of components of tissue engineering, clinical protocol and predictable outcomes for REP and recent advances in regenerative dentistry.
ABSTRACT
Background: Cefadroxil has good tissue penetration & exerts more sustained action at the site of infection after oral absorption. Our aim of the study was to check topical cefadroxil has any efficacy over staphylococcal superficial skin infection or not. Methods: Pre-treatment nasal swabs were obtained from 25 healthy human volunteers and bacterial load was recorded. After single application of topical cefadroxil 3% in left anterior nare and placebo (vehicle) in right anterior nare nasal swabs were obtained and results were compared. 150 patients with staphylococcal superficial skin infections were distributed in 4 groups: Group A - oral cefadroxil 500 mg twice daily for 5 days, Group B - topical cefadroxil (0.5 % to 5%) twice daily, Group C - cefadroxil 500 mg orally plus placebo (vehicle) topically twice daily and Group D -cefadroxil 500 mg orally plus cefadroxil preparation topically twice daily. Bacterial load was measured before treatment, on follow up &after clinical cure and results were compared. Results: Topical cefadroxil significantly reduced bacterial load after single application in anterior nare. Topical cefadroxil cured and significantly reduced bacterial load in staphylococcal superficial skin infections within 3 days of treatment. Oral plus topical cefadroxil combination therapy significantly reduced bacterial load and cured infection within 3 days of treatment in patients with moderate to heavy bacterial growth. No any adverse effect was observed during entire study period in any of groups. Conclusions: Topical preparation of cefadroxil is safe and effective in treating staphylococcal superficial skin infections. Combination of oral plus topical cefadroxil showed synergistic effect in infections with moderate to heavy growth. This study is registered at CTRI [REG ID: CTRI/2013/02/003433 REF: REF/2013/02/004576].