Evaluation of the Antibacterial efficacy of newly formulated Nano Triple Antibiotic paste with Nano Anti-inflammatory drug as a root canal medicament. (A double blind randomized clinical trial)

Abstract

Intracanal microorganisms' elimination is essential for root canal treatment long-term success. Proper mechanical preparation and irrigation in conjugation with intracanal medicaments can achieve this goal. The aim of this study was to evaluate the ability of Nano triple antibiotic paste with Nano diclofenac potassium anti-inflammatory drug (Nano TAPC) versus regular Triple antibiotic paste with diclofenac potassium anti-inflammatory drug (TAPC) and Calcium hydroxide (Ca (OH)2 ) used as intra-canal medication in reducing intracanal bacterial count. Methods: 60 patients with upper central incisors were chosen (all necrotic and asymptomatic) and then they were divided into three groups according to the intra-canal medication used: Ca (OH) 2, TAPC and Nano TAPC. Access cavity was performed for the targeted teeth followed by root canals preparation using rotary Protaper Next files with saline irrigation. Bacteriological samples were obtained from the root canals before (S1) and after instrumentation (S2) in the first treatment session. Subsequently, intracanal medication was placed and bacterial reduction was assessed in the second session after 3 days (S3) using colony forming unit test. Results: There was a statistically significant bacterial count reduction in all groups from S2 to S3. Nano TAPC intracanal medication achieved significant bacterial count reduction compared to that of TAPC intracanal medication and Ca (OH) 2. Conclusion: NTAPC as intracanal medication was more effective in reducing the root canal total bacterial count than that of the TAP and that of the Ca (OH) 2 in asymptomatic uniradicular necrotic teeth.