Double Antibiotic Paste Outperforms Calcium Hydroxide as Intracanal Medicament for Treating apical periodontitis: Study
Researchers have found in a new research that Double Antibiotic Paste (DAP) exhibited significantly better outcomes than Calcium Hydroxide in treating teeth with periapical (PA) lesions, suggesting Double Antibiotic Paste may be a more effective option for managing necrotic pulps and apical periodontitis.
The successful management of necrotic pulps and apical periodontitis poses a tough challenge in endodontic therapy, as it involves addressing compromised tooth vitality and microbial invasion of root canal systems. Failure to effectively treat these conditions can lead to persistent infection and severe patient discomfort.
The efficacy of double antibiotic paste (DAP), a mixture of ciprofloxacin and metronidazole, was evaluated and compared to calcium hydroxide (CH) by assessing radiographic and clinical outcomes of nonsurgical endodontic treatment in cases with necrotic pulps and the presence of apical periodontitis. Thirty maxillary anterior teeth with necrotic pulps and apical periodontitis (periapical index [PAI] = 5) were divided randomly into two experimental groups.
The first group received Calcium Hydroxide dressing, while the other group filled with Double Antibiotic Past as intracanal medicament. After 3 weeks, medicaments were removed, and teeth were obturated in both groups. Teeth were assessed clinically and radiographically at 6-month and 12-month follow-ups. A chi-square test was performed to compare the outcome between the groups.
Results: None of the teeth showed complete healing in a 6-month follow-up. At the 12-month follow-up, six samples in the Double Antibiotic Past group showed complete healing of the periapical (PA) lesion, while none of the samples in the Calcium Hydroxide group were completely healed. The PA healing outcome was as follows: in the Double Antibiotic Past group, 40% of cases were healed, 60% healing, and 0% diseased, while in the Calcium Hydroxide group, 0% healed, 93.3% healing, and 6.7% diseased.
The results of the two experimental groups in 12 months differed significantly (p  < 0.05). Double Antibiotic Past group has shown significantly better outcomes compared to Calcium Hydroxide as intracanal medicament in the treatment of teeth with PA lesions. This finding suggests that Double Antibiotic Pastmay offer a more effective therapeutic approach in managing necrotic pulps and apical periodontitis, potentially improving patient outcomes and treatment success rates.
Reference:
Rahmati, Afsaneh, Seyedein, Farshad, Dianat, Omid, Saedi, Sara, Rostami, Golriz, Akbarzadeh Baghban, Alireza, Sabertahan, Shima, Kazem, Majid, Effect of Calcium Hydroxide Versus Double Antibiotic Paste on Endodontic Treatment Outcomes in Teeth With Large Periapical Lesions: A Triple-Blind Randomized Clinical Trial, International Journal of Dentistry, 2024, 7071459, 7 pages, 2024.https://doi.org/10.1155/ijod/7071459
