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Triple antibiotic paste is an endodontic preparation that is ideal for treating primary teeth with a pulpotomy to avoid tooth extraction. This procedure using a mix of antibiotics minimizes instrumentation and is referred to as an endodontic regenerative procedure (ERP). The treatment technique is sometimes called Lesion Sterilization and Tissue Repair (LSTR). With LSTR, damaged tissues can be repaired through the disinfection of lesions achieved with triple antibiotic paste. This method has been demonstrated to produce a greater increase in dentin wall thickness and improved functional development of the pulp-dentin complex.
Three Effective Antibiotics in One
There are a variety of bacteria that can be present in an infection and some may be resistant to certain antibiotics. A single antibiotic used alone is not likely to provide complete sterilization. By combining three different antibiotics together for LSTR, the multiple types of bacteria that may be present in a root canal infection can be eliminated. The MP paste made with macrogol and propylene glycol is an excellent vehicle to carry the antibiotics into the dentin to kill the bacterial lesions.
Triple Antibiotic Paste Formulations
There are two formulations for triple antibiotic paste that we make that are both effective. The 3Mix MP is the “original” formulation but we now offer an alternate formulation based on requests from dentists who use the product. Each order of triple antibiotic paste comes packaged in two luer-lock syringes for mixing the antibiotic powder and the MP paste.
Metronidazole 33%, Minocycline 34%, and Ciprofloxacin 33% with a Macrogol and Propylene Glycol (MP) Paste
In one study, 83 out of 87 patients showed improvement in symptoms after one application of 3Mix paste. After treatment, gingival swelling and fistulae disappeared along with pain and teeth functioned normally. Mechanical procedures were avoided and only one office visit was required for the majority of patients. Although this particular study involved primary teeth, 3Mix can effectively eliminate bacteria from permanent teeth as well.
3Mix MP Alternate with Iodoform
Metronidazole 30%, Clindamycin 30%, Ciprofloxacin 30%, Iodoform 10% with a Macrogol and Propylene Glycol (MP paste)
This paste is based on the 3Mix MP formula but replaces minocycline with clindamycin. Clindamycin is used as an alternative antibiotic to prevent possible tooth staining with minocycline. Iodoform is also included in this triple antibiotic paste to make it radiopaque.
- A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. – Journal of Endodontics
- Endodontic treatment of primary teeth using a combination of antibacterial drugs. – International Endodontic Journal
- Efficacy of Lesion Sterilization and Tissue Repair in Primary Tooth with Internal Resorption: A Case Series – Contemporary Clinical Dentistry