Effect of Irrigation With Antibiotic-containing Solutions on Postoperative Pain and Intra-canal Bacteria
Necrotic Pulp
About this trial
This is an interventional treatment trial for Necrotic Pulp focused on measuring antibiotic-containg solution, co-amoxiclav-clindamycin solution, MTAD, sodium hypochlorite, postoperative pain, antimicrobial efficacy, root canal irrigation
Eligibility Criteria
Inclusion Criteria:
Maxillary/mandibular single-rooted permanent teeth:
- Diagnosed clinically with pulp necrosis.
- Absence of spontaneous pain.
- Normal/slight widening in the periodontal membrane space (PMS).
- Patients' acceptance to participate in the trial.
- Patients who can understand numerical rating scale (NRS) and can sign the informed consent.
Exclusion Criteria:
- Medically compromised patients: Pain levels and healing following treatment would be compromised as these patients show higher incidence of pain and lower healing rate.
- Patients with known allergy to penicillin or penicillin derivatives.
- Pregnant females: Avoid radiation exposure, anesthesia, and medication.
- If analgesics or antibiotics have been administrated by the patient during the past 24 hours preoperatively: Might alter their pain perception.
- Patients reporting bruxism or clenching: Avoid further pressure on an already inflamed tooth inducing subsequent irritation and inflammation.
- Teeth that show association with acute periapical abscess and swelling: Need special treatment steps which could involve additional visits with incision and drainage. Also, it could influence initiation and progression of postoperative pain.
- Greater than grade I mobility or pocket depth greater than 5mm. Need special surgical and/or periodontal therapy.
- Non-restorable teeth.
- Immature teeth.
- Radiographic evidence of periapical radiolucency, external or internal root resorption, vertical root fracture, perforation or calcification.
Sites / Locations
- Endodontic Department - Faculty of Dentistry - Cairo University
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
Root canal irrigation with co-amoxiclav-clindamycin solution
Root canal irrigation with MTAD
Root canal irrigation with 2.5% sodium hypochlorite
Alternate irrigation with 1 mL antibiotic-containing solution followed by 4 mL 2.5% sodium hypochlorite solution between each size instrument and the consequent one. The antibiotic-containing solution will be prepared by mixing equal quantities of 1.2 gm Co-amoxiclav solution and 600 mg Clindamycin solution at a ratio of 1:1 by volume.
Irrigation with 5 mL MTAD irrigating solution for 5 minutes between each size instrument and the consequent one.
Irrigation with 5 mL 2.5% sodium hypochlorite irrigating solution between each size instrument and the consequent one.