Radiographical Assessment of Periapical Lesion Resolution Following Nonsurgical Root Canal Treatment with Different Irrigation Protocols and Intracanal Medicaments

Aim: To evaluate healing following nonsurgical treatment of periapical lesions using different intracanal medicaments and irrigation protocols.Materials and methods: Seventy-eight patients having periapical lesion were selected and randomly allocated into six equal groups based on the irrigation protocol followed and the intracanal medicament administered.The groups allocated were: positive pressure irrigation group (group I) and negative pressure irrigation group (group II).The subgroups were modified triple antibiotic paste (group Ia/IIa), photoactivated disinfection (group Ib/IIb), and calcium hydroxide (group Ic/IIc) subgroups.The patients were assessed radiographically based on the designated parameters at intervals of 3, 6, and 12 months.The data obtained were analyzed using one-way ANOVA with GPower software version 3.0.Kruskal Wallis test and Friedman test were used for intergroup comparison.An alpha level of 5% (p-value was <0.05) was considered significant.Results: Group II showed significantly better results than group I at 6 and 12 months (p = 0.042, 0.029).Group IIb showed the best healing at all time frames.Groups Ia and IIa showed better healing than group Ic and IIc at 6 and 12 months.Groups Ic & IIc showed the least amount of healing. Conclusion:The use of photoactivated disinfection (PAD) as an intracanal medicament and negative pressure irrigation for canal disinfection resulted in superior healing of periapical lesions.Clinical significance: Photoactivated disinfection resulted in superior canal disinfection followed by triple antibiotic paste and with negative pressure irrigation eventualized in better healing of periapical lesions.Calcium hydroxide was the least effective in canal disinfection and periapical lesion healing.