Comparison of Calcium Hydroxide, Chlorhexidine and Triple Antibiotic Paste As Intracanal Medicaments In Patients With Acute Periapical Infections
DOI:
https://doi.org/10.51985/JBUMDC2019001Keywords:
Intra-canal Medicaments, Periapical Infection, Post-operative PainAbstract
Objective: To compare the effects of calcium hydroxide, triple antibiotic paste (TAP) and chlorhexidine (CHX) as the
intra-canal medicaments in post-operative pain reduction.
Study Design and Setting: This was a Quasi experimental study conducted in Bahria University Medical and Dental
College, Department of Operative Dentistry for the period of six months.
Methodology: Patients with acute periapical infections in single rooted teeth were divided into 3 groups. Group 1 received
Calcium hydroxide, group 2 received Chlorhexidine and group 3 received Triple antibiotic paste as intracanal medicament.
Each group comprised of 30 patients therefore the total participants of the study were 90. Patients were recalled on 2nd,
7th and 15th day postoperatively and the pain was recorded by using Visual Analogue Scale.
Results: Among the study participants; two patients receiving calcium hydroxide were pain free after 2 days and this
number increased to 11patients after 7 days. From the CHX group; nine patients were pain free after two days and 23
patients reported no pain after 7 days. In TAP paste group 3 patients reported no pain after 2 days and 22 after 7 days. No
patient reported pain after 15 days in any group. Data was statistically analyzed by using SPSS version 23 and Chi-square
test was used for descriptive analysis.
Conclusion: Intra-canal medicaments significantly reduced inter-appointment pain. The chlorhexidine and triple antibiotic
paste were more effective as compared to calcium hydroxide.
References
. Lakhani A.A, Sekhar K.S, Gupta .P, Efficacy of Triple Antibiotic Paste, Moxifloxacin, Calcium Hydroxide And 2% Chlorhexidine Gel In Elimination of E. Faecalis: An In vitro Study, J Clin Diag Res 2017;11(1):6-9
Ghoddusi J, Javidi M, Zarrabi MH, Bagheri H. Flare-ups incidence and severity after using calcium hydroxide as intracanal dressing. N Y State Dent J. 2006;72(4):24-8.
Khattak YK, Shah SA, Alam F. Comparison of inter appointment pain between calcium hydroxide mixed with 2% chlorhexidine and calcium hydroxide mixed with normal saline; a randomized controlled trial. JKhyb Col Dent 2014; 5(1): 33-37
Chong B, Ford TP. The role of intracanal medication in root canal treatment. Int Endod J. 1992;25(2):97–106.
Mohammadi Z. Antibiotics as Intracanal Medicaments: A Review..J Calif Dent Assoc. 2009;37(2):98-108
Moller AJR, Lars F, Gunnar D. Apical peri¬odontitis development and bacterial response to end¬odontic treatment. Experimental root canal infections in monkeys with selected bacterial strains. Euro J Oral Sci 2004;112(3):207-15
George S, Kishen A, Song P. The role of environmental changes on monospecies biofilm formation on root canal wall by Enterococcus faecalis. J Endod. 2005;31(12):867–72
Ferraz C, Dealmeidagomes B, Zaia A, Teixeira F, Desouzafilho F. In vitro assessment of the antimicrobial action and the mechanical ability of chlorhexidine gel as an endodontic irrigant. J Endod. 2001;27(7):452-55
Mohammadi Z, Abbott P. The properties and applications of chlorhexidine in endodontics. Int Endod J. 2009;42(4):288-302
Fuss Z, Rafaeloff R, TaggerM , Szajkis S. Intracanal ph changes of calcium hydroxide pastes exposed to carbondioxide in vitro. JEndod 1996;22:362-364
Nosrat A, Seifi A, Asgary S. Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod. 2011;37(4):562-7
Thibodeau B, Teixeira F, Yamauchi M, Caplan DJ, Trope M. Pulp revascularization of immature dog teeth with apical periodontitis. J Endod. 2007;33(6):680-9
Petrino JA, Boda KK, Shambarger S, Bowles WR, McClanahan SB. Challenges in regenerative endodontics: a case series. J Endod. 2010;36(3):536-41
Jung IY, Lee SJ, Hargreaves KM. Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series. J Endod. 2008;34(7):876-87
Bose R, Nummikoski P, Hargreaves K. A retrospective evaluate on of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. J Endod. 2009;35(10):1343-9
Dall A.Q, Jouhar R, Khoso N.A. Comparison of inter-appointment pain between ledermix and nointracanal medicament in acute apical periodontitis. JLUMHS. 2011;10(3):106-11
Mohammadi Z, Abbot PV. The properties and application of chlorhexidine in endodontics IntEndodJ.2009 ;42:288-302
Almyroudi A, Mackenzie D, McHugh S, Saunders WP. The effectiveness of various disinfectants used asendodontic intra canal medications: an in vitro study.J Endod 2002;28:163-7
Krithikadatta J, Indira R, Dorothykalyani AL. Disinfection of dentinal tubuleswith 25 chlorhexidine,25metronidazole, bioactive glasswhen compared with calcium hydroxide as intracanal medicaments. JEndod. 2007;33:1473-6
Siqueira JF, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. I Endod J 1999;32:361-9
Gomes BP, Souza SF, Ferraz CC, Teixeira FB, Zaia AA, Valdrighi L et al. Effectiveness of 2% chlorhexidine gel and calcium hydroxide againstEnterococcus faecalis in bovine root dentine in vitro. Int Endod J2003;36:267-75
de Souza-Filho FJ, Soares A de J, Vianna ME, Zaia AA, Ferraz CC, Gomes BP. Antimicrobial effect and pH of chlorhexidine gel and calciumhydroxide alone and associated with other materials. Braz Dent J2008;19:28- 33
Gomes BP, Vianna ME, Sena NT, Zaia AA, Ferraz CC, de Souza Filho FJ.In vitro evaluation of the antimicrobial activity of calcium hydroxidecombined with chlorhexi¬dine gel used as intracanal medicament. OralSurg Oral Med Oral Pathol Oral Radiol Endod 2006;102:544-50
Barbosa CAM, Goncalves RB, Siqueira JF, De Uzeda M. Evaluation of the antibacterial activities of calcium hydroxide, chlorhexidine, and camphorated paramonochlorophenol as intra canal medicament. A clinical and laboratory study. J Endod 1997;23:297-299
Signoretti FGC, Gomes BP, Montagner F, Tosello FB, Ja¬cinto RC. Influence of 2% chlorhexidine gel on calcium hydroxide ionic dissociation and its ability of reducing endotoxin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:653-8
Adl A, Shojaee NS, Motamedifar M. A comparison between the antimicrobial effects of triple antibiotic paste and calcium hydroxide against Entrococcus faecalis.Iran Endod J. 2012;7(3):149-55.
Mozayeni MA, Haeri A, Dianat O, Jafari AR. Antimicrobial effects of four intracanal medicaments on Enterococcus faecalis: An in vitro study. Iran Endod J. 2014;9(3):195-98.
Madhubala MM, Srinivasan N, Ahamed S. Antimicrobial effectiveness of intracanal medicaments on Enterococcus faecalis: Chlorhexidine versus octenidine. Int Endod J 2011;37(9):1287–9
Adl A, Shojaee NS, Motamedifar M. A comparison between the antimicrobial effects of triple antibiotic paste and calcium hydroxide against Entrococcus faecalis. Iran Endod J. 2012;7(3):149–55.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 Syed Adeel Ahmed, Shama Asghar, Safia Anwar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0 
