Clinical effect of calcium hydroxide paste combined with triple antibiotic paste on root canal disinfection

Objective To compare the efficacy in disinfection and pain control of calcium hydroxide paste and triple antibiotic paste(ornidazole, ciprofloxacin and minocycline) used individually or jointly for root canal disinfection. Methods Two hundred and thirty-five patients with chronic apical periodontitis(235 teeth) were involved in the present study and divided into 2 groups: fistula group(n=118) and no fistula group(n=117). Each group was then randomly divided into 4 subgroups: calcium hydroxide paste group, triple antibiotic paste group, calcium hydroxide + triple antibiotic paste group, and camphor phenol group. After regular root canal preparation, root canals of patients in 4 groups were filled with tiny paper ends impregnated with fore 4 different drugs respectively. Visual analogue scales(VAS) of pain were given to the patients with a guide for filling the scale. One week later, both the data of the scales and the effects of root canal disinfection were recorded and analyzed. Results Seven days after treatment, the clinical efficacy of calcium hydroxide paste, triple antibiotic paste and calcium hydroxide + triple antibiotic paste was similar(P0.05) either in fistula group or in no fistula group, but all better than that of camphor phenol(P0.05). VAS score analysis showed that, at least on the first 3 days after sealing medicine in the root canal, calcium hydroxide + triple antibiotic paste achieved better result of pain control than the other three groups(P0.05) no matter with or without fistula. Conclusions Calcium hydroxide paste, triple antibiotic paste, calcium hydroxide + triple antibiotic paste are effective in treatment of chronic apical periodontitis whether with or without fistula. However, the combined use of calcium hydroxide and three antibiotic pastes is better for controlling the pain after root canal preparation than other treatments, which is therefore worthy of clinical application.