The Effect of Calcium Hydroxide, Triple Antibiotic Paste and Chlorhexidine on Pain in Teeth with Symptomatic Apical Periodontitis: A Randomised Controlled Trial

Asma Munir Khan, Irfana Khursheed Ahmed Gangoo, Naila Amir Ali, Mansoor Khan, Muhammad Qasim Javed (), Mustafa Hussein AlAttas, Ayman M. Abulhamael, Hammam Ahmed Bahammam, Loai Alsofi and Rayan Suliman Al Yahya
Additional contact information
Asma Munir Khan: Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraidah 52571, Saudi Arabia
Irfana Khursheed Ahmed Gangoo: Endodontics Specialty Clinics, Qassim University Medical City, Buraidah 52571, Saudi Arabia
Naila Amir Ali: Department of Operative Dentistry, Bolan University of Medical and Health Sciences, Quetta 87300, Pakistan
Mansoor Khan: Department of Operative Dentistry, Foundation University College of Dentistry, Foundation University, Rawalpindi 44000, Pakistan
Muhammad Qasim Javed: Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraidah 52571, Saudi Arabia
Mustafa Hussein AlAttas: Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraidah 52571, Saudi Arabia
Ayman M. Abulhamael: Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia
Hammam Ahmed Bahammam: Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
Loai Alsofi: Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia
Rayan Suliman Al Yahya: Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraidah 52571, Saudi Arabia

IJERPH, 2023, vol. 20, issue 4, 1-11

Abstract: Background: One of the main reasons for post endodontic pain is the polymicrobial intracanal flora that may survive the initial disinfection. A single antimicrobial agent might not provide adequate disinfection, and an antimicrobial combination such as triple antibiotic paste was tested to achieve this goal. Aim: The study aimed to assess the efficacy of three intra-canal medicaments on post root canal preparation pain. Materials and Methods: Eighty patients with single-rooted necrotic teeth and symptomatic apical periodontitis were randomly assigned to four treatment groups ( n = 20). Their preoperative pain was recorded on Wong-Baker’s FACES pain rating scale. After chemo-mechanical canal preparation, intracanal medications were applied to the groups (Group 1 (20% calcium hydroxide), Group 2 (2% chlorhexidine), Group 3 (tri-antibiotic paste), Group 4 (no medication (Control group)). Patients were instructed to record pain on the Wong-Baker FACES pain rating scale at 4, 48, 72 and 96 hrs, postoperatively. Pain scores were analyzed using a one-way ANOVA test and Tukey’s post hoc test and, if significant, Dunn’s test was used for pair-wise comparisons. The significance level was set at a p -value ≤ 0.05. Results: Tukey’s post hoc test revealed significantly lower pain scores in Group 3 compared with other groups at all follow up intervals. Dunnett’s test showed significantly lower pain in Group 3 compared with the Control group at 48, 72 and 96 hrs, postoperatively. Conclusions: Triple-antibiotic paste showed effective pain control as an intracanal medication on necrotic teeth with symptomatic apical periodontitis.

Keywords: intracanal medicament; oral diseases; oral health; pain management; periapical periodontitis; calcium hydroxide; chlorhexidine; endodontics; randomized controlled trial (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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