Clinical and radiographical evaluation of the healing of large periapical lesions using triple antibiotic paste, photo activated disinfection and calcium hydroxide when used as root canal disinfectant

Abstract

Objectives: To evaluate clinically and radio graphically, the healing following nonsurgical treatment of periapical lesions when Photo Activated Disinfection(PAD), triple antibiotic paste and calcium hydroxide was used as root canal disinfectant. Material and Methods: Sixty patients (20 for PAD, 20 for triple antibiotic paste, 20 for calcium hydroxide) with periapical lesions in the maxillary and mandibular anterior region were selected from the outpatient section of the Department of Conservative Dentistry & Endodontics, Govt. Dental College, Kozhikode to participate in this study. The patients were selected with a preoperative score of 4 or 5. There were no significant differences for the PAI Scores between the three groups at the start of the experiment .Intracanal disinfection was done in the three groups followed by obturation. The patients recalled at 3,6,12,18 months interval. Results: At 18 months follow up 15 % of cases failed in calcium hydroxide group,5% in triple antibiotic paste and no failure cases were seen in PAD group. Success criteria were divided into strict and loose, while the former had statistically significant p value the latter did not. Kruskal-Wallis Test showed an increased mean value for PDT and a significant change in p value. Bonferroni post hoc test was done to compare if there is any significant change between groups. Only significant change was found between calcium hydroxide and photoactivated disinfection . Conclusion: PAD was more effective intracanal disinfectant at 6,12 and 18 months. Key words:Calcium, hydroxide, photo activated disinfection, triple antibiotic paste, root canal disinfection

An in vivo study to compare anti microbial activity of triantibiotic paste, 2% chlorhexidine gel, and calcium hydroxide on microorganisms in the root canal of immature teeth

“…In the present study, triple antibiotic paste showed a considerable decrease in microbial pathogens from root canal of the sample teeth, the results of the present study were concordance with various studies conducted in the past. [121314171819] In a study conducted on dog teeth (immature) affected with apical periodontitis by Windley et al [19] shows a considerable decrease in bacterial pathogen from root canal.…”

“…[11] The use of these antibiotics as intracanal medicament also been explored in various studies. [12131415] In the Indian scenario, there are no studies done which could explore the use of these antibiotics in combination as an irrigating solution except or one study where few of these antibiotics were used as an irrigant solution. [16] The combination of various antibiotics such as ciprofloxacin, metronidazole, and tetracycline and its use and efficacy has not yet been researched yet.…”

Learning from clinical phenotypes: Low‐dose biophotonics therapies in oral diseases

“…In another long follow-up study, Johns et al observed the clinical and radiographic evolution of the healing of large periapical lesions following three treatments, namely aPDT, triple antibiotic paste, and calcium hydroxide. In their conclusions, the authors report that aPDT was a more effective intracanal disinfectant at 6-, 12-, and 18-month follow-up (Johns et al, 2014). All these studies together indicate the effectiveness of aPDT in improving endodontic therapy success rates and should be pursued in future studies.…”

Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: 3-Dimensional Analysis Using Cone-Beam Computed Tomography on the Outcomes of Non-Surgical Endodontic Treatment Using A-PRF+ and Calcium Hydroxide: A Retrospective Cohort Study

“…There are supplementary procedures that may probably enhance periapical lesion healing, such as: using a triple antibiotic paste (Hoshino paste containing Ciprofloxacin 500 mg, Metronidazole 400 mg, and Minocycline 100 mg) as a canal dressing, photo-activated disinfection (PAD) or magnetostimulation. However, there is still a need for further study in order to confirm their abilities [ 8 , 9 ]. RCT with a mineral trioxide aggregate (MTA) as an apical closure can be used for the apexification of an immature tooth with a large periapical lesion [ 10 ].…”