Influence of different forms of calcium hydroxide and chlorhexidine intracanal medicaments on the outcome of endodontic treatment of teeth with chronic apical periodontitis

Abstract

Introduction/Objective The aim of this study was to determine clinical and radiographic periapical healing of teeth with apical periodontitis treated with different formulations of calcium hydroxide (CH) - paste (CH-paste) and gutta-percha points (CH-GP) - as well as those of chlorhexidine (CHX) - gel (CHXgel) and gutta-percha points (CHX-GP) -12 months after therapy. Methods Eighty patients with chronic apical periodontitis were randomly allocated to four treatment groups according to the intracanal medicament used: CH-paste, CH-GP, CHX-gel, and CHX-GP group. Seventy-eight patients were analyzed clinically and radiographically 12 months postoperatively. The periapical index (PAI) was used for the radiographic evaluation of treatment. Results Overall outcome was classified according to radiographic evaluation only, since clinical success was observed in all the patients. In all the groups, significant reduction in PAI scores was observed (p lt 0.001). The proportions of healed teeth (PAI ≤ 2) were 73.7%, 60%, 68.4%, and 65% in CH-paste, CH-GP, CHX-gel and CHX-GP group, respectively, with no significant differences between the groups. Conclusion The results suggest that there are no differences between investigated CH- and CHX-delivery systems regarding treatment outcome of teeth with apical periodontitis.

Uvod/Cilj Cilj ovog istraživanja je bio da se ispita klinički i radiografski ishod lečenja zuba sa apeksnim periodontitisom 12 meseci posle završene terapije i primene različitih oblika kalcijum-hidroksida (KH): pasta (KH-pasta) i gutaperka poeni (KH-GP) i hlorheksidina (HH): gel (HH-gel) i gutaperka poeni (HH-GP). Metode Randomizovano je 80 ispitanika sa hroničnim periapeksnim lezijama u četiri grupe na osnovu vrste korišćenog interseansnog medikamenta: KH-pasta, KH-GP, HH-gel i HH-GP. Dvanaest meseci posle završenog lečenja pregledano je 78 ispitanika i urađeni su retroalveolarni snimci. Za procenu radiografskog uspeha lečenja korišćen je periapikalni indeks (PI). Rezultati Ishod lečenja je klasifikovan na osnovu radiološkog nalaza jer je kod svih ispitanika zabeležen klinički uspeh lečenja. U svim ispitivanim grupama je zabeleženo značajno smanjenje vrednosti PI (p lt 0,001). Izlečenje (PI ≤ 2) uočeno je kod 73,3% zuba u grupi KH-pasta, 60% u KH-GP grupi, 68,4% u grupi HH-gel i kod 65% zuba u grupi HH-GP, pri čemu razlike između grupa nisu bile statistički značajne. Zaključak Rezultati ovog istraživanja pokazuju da ne postoji razlika u ishodu lečenja zuba sa apeksnim periodontitisom posle primene ispitivanih oblika KH i HH.