Abstract
Aim This study aimed to compare the antimicrobial efficacy of calcium hydroxide (CH) and triple antibiotic paste (TAP) against E. faecalis bacteria in infected primary molars. Methods and Materials Thirty-nine 4–6-year-old children with an infected primary molar were randomly divided into three equal groups (n = 13) to receive either CH or TAP and an untreated control group. Following access cavity preparation, the first microbiological samples (S1) were collected by using absorbent paper points. The canals were prepared and rinsed. Then, CH or TAP was applied in the root canals. Seven days later, the second microbiological samples (S2) were collected. DNA extraction was performed to count E. faecalis bacteria by using real-time PCR for S1 and S2 samples. Data were analyzed through one-way ANOVA and Tukey's test (α = 0.05). Results E. faecalis bacteria counts decreased significantly in CH and TAP groups compared with the control group (P ≤ 0.001). However, no statistically significant difference existed between these two groups (P=0.698). Conclusion Both TAP and CH have significant antimicrobial effects as intracanal medicament between the treatment sessions in infected primary teeth.
Highlights
Bacteria are known as a major cause of pulpal and periapical diseases [1, 2]. e complex nature of the root canal system necessitates a combination of mechanical instrumentation and irrigation to reduce the microorganisms in the root canal [3]
E patients were randomly allocated into three groups (n 13 per group) to receive either calcium hydroxide paste (1 gm Calcium hydroxide (CH) mixed with 1 mL distilled water) or triple antibiotic paste as the intracanal medicament
Based on the previous similar in vivo studies [7] and concerns about the cytotoxic effects of formocresol on the periapical area [20], the negative control group with no medicament was considered to compare the pure antimicrobial effect of intracanal medicaments. e group allocation was performed by an assistant not directly involved in the study after each patient was seated for the first appointment. e patients and the data evaluators were blinded to the type of the employed intracanal agent
Summary
Bacteria are known as a major cause of pulpal and periapical diseases [1, 2]. e complex nature of the root canal system necessitates a combination of mechanical instrumentation and irrigation to reduce the microorganisms in the root canal [3]. Calcium hydroxide (CH) is commonly used in endodontics as an intracanal medicament between the treatment sessions for necrotic permanent teeth [8, 9]. It does not affect some bacterial strains such as E. faecalis [9,10,11]. Infections in the primary root canals are associated with a broad variety of microorganisms, among which E. faecalis is one of the most prevalent and resistant bacteria species in both deciduous and permanent root canals [8, 12,13,14]
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