Comparison of Anti-microbial Efficacy of Calcipex and Metapex in Endodontic Treatment of Chronic Apical Periodontitis
Status:
Completed
Trial end date:
2021-04-30
Target enrollment:
Participant gender:
Summary
Introduction:
Pulpal necrosis may lead to spread of the infection from the pulp to involve the apex of the
tooth and surrounding bone which when asymptomatic with periapical radiolucency on
radiograph, is called chronic apical periodontitis. In order to eliminate the virulent
bacteria and to overcome the inflammation in the root apex, endodontic treatment is the
treatment of choice. Bacteria usually survive in the complex anatomy of the root canal
system. In order to eliminate the remaining bacteria, various intracanal medicaments have
been used widely however, there is controversy over their use and efficacy. Calcium hydroxide
(CH) is the most commonly used intracanal medicament between root canal treatment sessions
and available in different combinations. Multiple studies have been conducted to evaluate the
effect of various types of CH based medicaments but whether CH with iodoform is more
effective than CH alone against endodontic pathogens is a matter of controversy. In order to
evaluate the true reduction in microbial load from the infected canals, microbial culture is
a predictable and convenient tool.
Thus, this study aims to evaluate the antimicrobial effectiveness of inter-appointment
intracanal medicament with either CH alone (Calcipex) or CH with iodoform (Metapex) for the
treatment of infected root canals of teeth diagnosed with chronic apical periodontitis using
colony forming unit (CFU).
Objective: To compare the anti-microbial efficacy of calcipex and metapex in endodontic
treatment of teeth diagnosed with chronic apical periodontitis and to compare two different
methods for removal of oil based intracanal medicaments.
Method: Approval from ERC is obtained. The selected subjects will be divided in to two study
groups using a computer generated randomization list i.e., Group A - Calcipex group (n = 30)
and Group B - Metapex group (n = 30). Two samples will be collected from the root canals for
evaluation of microbial load after chemomechanical preparation (S1) (before use of intracanal
medicament) and after usage of intra canal medicament (S2)(after 7 days).
Two techniques will be used for removal of oil based medicaments. Two radiographs will be
obtained for each technique, after oil based medicament placement and after medicament
removal for evaluation.
Data Analysis: Mean and standard deviation of continuous variable will be computed. Frequency
distribution and proportion of categorical variables will be determined. Paired t-test will
be used to assess difference bet¬ween antimicrobial efficacies within groups of medicaments.
Independent sample t-test will be used to assess antimicrobial efficacies between groups.
Level of significance will be kept at 0.05.
Mann whitney U test will be used to evaluate medicament removal between 2 groups and at three
canal levels; coronal, middle and apical.