The effect of triple antibiotic paste as an intracanal medication with an anti-inflammatory drug on post-operative pain of asymptomatic uniradicular necrotic teeth : A double blind randomized clinical trial / Mohamed Omaia Ahmed Salah ; Supervised Maged M. Negm , Yousra M. Nashaat , Nehal Nabil

Thesis (Ph.D.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Endodontics

Aim: To assess the ability of triple antibiotic paste with diclofenac potassium anti-inflammatory drug versus calcium hydroxide used as intra-canal medication in reducing post-operative pain as well as intracanal bacterial count. 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 anti-inflammatory drug group (TAPC). After isolation, access cavity was performed followed by chemo-mechanical preparation using rotary Protaper Universal files with saline irrigation in the first treatment session. While in the second treatment session, intra-canal medication was placed and postoperative pain was assessed at 24, 48 and 72 hours postoperatively using VAS. Bacteriological samples obtained from the root canals before (S1) and after instrumentation (S2) in the first treatment session. Subsequently, intra-canal medication was placed and bacterial reduction was assessed in the second session after 3 days (S3) using colony forming unit test. 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 Ca(OH)₂ at 24, 48 and 72 hours with a statistically significant difference at 48 hours only. Both intracanal medicaments showed a statistically significant bacterial count reduction from S2 to S3. TAP+Catafast intracanal medication achieved significant bacterial count reduction compared to that of Ca-OH₂

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