Comparison of Calcium Hydroxide and Triple Antibiotic Paste as Intracanal Medicament in Emergency Pain Reduction: In vivo Study

Endodontic posttreatment pain remains to be a significant problem facing the dental profession. Antibacterial intracanal dressing has been advocated to eliminate remaining bacteria after chemomechanical preparation.1 Various intracanal medicaments are advocated to eliminate bacteria and prevent multiplication of bacteria between the appointments. Calcium hydroxide (CH) has been the most commonly used medicament, and its dressing is shown to provide more bacteria-free canals than those devoid of any dressing.2,3 Local application of antibiotics in the root canal has been suggested to overcome the potential risks of adverse systemic effects of antibiotics and as an effective mode for drug delivery in teeth lacking blood supply due to necrotic pulps or pulp-less status because root canal infections are polymicrobial consisting of both aerobic and anaerobic bacterial species. Single antibiotic may not be effective in canal disinfection. Therefore, combination antibiotics mainly consisting of ciprofloxacin, metronidazole, and minocycline, referred as triple antibiotic paste (TAP) has been suggested for root canal disinfection.4 Various studies have shown that minocycline causes potential tooth discoloration.5 Recent studies have shown that clindamycin or cefaclor can be other substitute for TAP.