Abstract
Background:Flare-ups may occur after root canal treatment which consist of acute exacerbation of asymptomatic pulpal and/or periradicular pathologic condition. The causative factors of interappointment pain include mechanical, chemical or microbial irritation to the pulp or periradicular tissues. The potential role of microorganisms in interappointment pain is why the success of endodontic treatment depends on complete eradication of microorganisms capable of causing an intraradicular or extraradicular infection. This can be achieved by mechanical cleaning and shaping, in conjunction with irrigation and antibacterial agents. The aim of this study was to assess the ability of triple antibiotic paste with the anti-inflammatory drug diclofenac potassium versus calcium hydroxide used as an intra-canal medication in reducing post-operative pain.Methods:84 patients with asymptomatic uniradicular necrotic teeth were randomly assigned into two groups according to the intra-canal medication used: calcium hydroxide group (CH) and triple antibiotic paste with diclofenac potassium group (TAPC). In the first treatment session, intracoronal cavity preparation was performed after rubber dam isolation followed by chemo-mechanical preparation using rotary Protaper Universal files with saline irrigation followed by intra-canal medication placement then postoperative pain was assessed at 24, 48 and 72 hours postoperatively using Visual Analogue Scale (VAS). In the second treatment session, intracanal medications were removed by irrigation using saline followed by obturation.Results:Both intracanal medicaments resulted in a statistically significant decrease in mean pain value from 24 to 48 and 72 hours postoperatively. While when comparing both groups, TAPC intracanal medication showed less post-operative pain compared to that of the CH group at 24, 48 and 72 hours with a statistically significant difference at 48 hours only.Conclusion:Both intracanal medicaments were efficient in reducing post-operative pain in asymptomatic uniradicular necrotic teeth.Trial registration:Clinicaltrial.govNCT02907489, 20/09/2016.
Highlights
The severity and incidence of post-operative pain are usually associated with specific dental treatments; the highest of which is root canal therapy[1].Post-operative pain is a common finding after endodontic treatment, its incidence ranges from 3% to 58%
I-Demographic data 93 patients were assessed for eligibility, 9 patients were excluded (5 were not meeting inclusion criteria while 4 declined to participate); in total 84 patients were randomly assigned, received intended treatment, and were analysed for the primary outcome. 3 participants were lost during follow up period after the first treatment session (2 from calcium hydroxide group (CH) group and 1 from triple antibiotic paste with diclofenac potassium group (TAPC) group) as they refused to continue and their treated tooth was extracted, implants to replace the extracted tooth were offered but none of the participants elected to have one
A CONSORT flow diagram is available as part of the reporting guidelines
Summary
The severity and incidence of post-operative pain are usually associated with specific dental treatments; the highest of which is root canal therapy[1].Post-operative pain is a common finding after endodontic treatment, its incidence ranges from 3% to 58%. The potential role of microorganisms in interappointment pain is why the success of endodontic treatment depends on complete eradication of microorganisms capable of causing an intraradicular or extraradicular infection. This can be achieved by mechanical cleaning and shaping, in conjunction with irrigation and antibacterial agents. The aim of this study was to assess the ability of triple antibiotic paste with the antiinflammatory drug diclofenac potassium versus calcium hydroxide used as an intra-canal medication in reducing post-operative pain. Methods: 84 patients with asymptomatic uniradicular necrotic teeth were randomly assigned into two groups according to the intra-canal medication used: calcium hydroxide group (CH) and triple antibiotic paste with diclofenac potassium group (TAPC). In the second treatment session, intracanal medications were removed by irrigation using saline followed by obturation
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