Riaz Amna, Maxood Anser, Abdullah Saeeda, Saba Kiran, Din Shahab Ud, Zahid Shahreen
Department of Operative Dentistry, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.
National University of Medical Sciences, Rawalpindi-Pakistan.
J Ayub Med Coll Abbottabad. 2018 Jul-Sep;30(3):320-324.
As a gold standard, calcium hydroxide has always been used as a root canal medicament against root canal pathogens but its combination with chlorhexidine is not being employed in routine despite its documented efficacy and results. The objective of the study is to compare calcium hydroxide and combination of calcium hydroxide with 2% CHX on the basis of radiographic evidence of resolution of periapical radiolucency when they are used as an interappointment dressing /intracanal medicament for 14 days..
A total of 60 patients of either gender was included in the study. The age range was 15-60 years with the radiographic evidence of radiolucency of 2-4 mm in size. Both maxillary and mandibular teeth till first molar were selected. Teeth with previous endodontic treatment mentally handicapped and terminally ill patients were excluded. Selected patients were placed randomly into Group 1 (calcium hydroxide alone) and in Group 2 (calcium hydroxide in combination with 2% chlorhexidine gel). Obturation and permanent filling was done at 14th day. The patient was recalled after 90 days of obturation and a radiograph was taken. Final outcome was measured at the end of 90thday of obturation.
The mean of percentage reduction in size of apical radiolucency at 3 months was 91.03% for group 1 and 97.26% for group 2 with p-value 0.13 (not significant). The results suggested equivalent results after medication with 2%chlorhexidine with calcium hydroxide but 2% chlorhexidine still showed better results than the group without CHX in terms of healing.
This study concluded that calcium hydroxide in combination with 2% chlorhexidene as intracanal medicament results in better resolution of periapical radiolucency in terms of percentage resolution of periapical radiolucency.
作为一种金标准,氢氧化钙一直被用作根管药物来对抗根管病原体,但其与洗必泰的联合使用尽管有文献记载的疗效和结果,但在常规治疗中并未被采用。本研究的目的是根据根尖周透射区在作为封药/根管内药物使用14天时的影像学证据,比较氢氧化钙以及氢氧化钙与2%洗必泰的联合使用情况。
本研究共纳入60例患者,性别不限。年龄范围为15至60岁,有大小为2至4毫米的透射区影像学证据。上颌和下颌直至第一磨牙的牙齿均被选取。曾接受过牙髓治疗的牙齿、智力障碍患者和绝症患者被排除。将入选患者随机分为第1组(单独使用氢氧化钙)和第2组(氢氧化钙与2%洗必泰凝胶联合使用)。在第14天进行根管充填和永久充填。根管充填90天后召回患者并拍摄X光片。在根管充填第90天结束时测量最终结果。
第1组在3个月时根尖周透射区大小减小百分比的平均值为91.03%,第2组为97.26%,p值为0.13(无统计学意义)。结果表明,使用2%洗必泰与氢氧化钙联合用药后效果相当,但在愈合方面,2%洗必泰仍比未使用洗必泰的组表现出更好的效果。
本研究得出结论认为,氢氧化钙与2%洗必泰联合作为根管内药物,在根尖周透射区的百分比分辨率方面能更好地消除根尖周透射区。