Comparative study of calcium hydroxide versus triple antibiotic paste as intracanal medicaments

Abstract

Persistent microorganisms, particularly Enterococcus faecalis, may survive chemomechanical preparation and compromise root canal disinfection, necessitating effective intracanal medicaments. Therefore, it is of interest to evaluate the 100 patients with necrotic single-rooted teeth, randomly allocated to calcium hydroxide (n=50) or triple antibiotic paste (n=50), assessing postoperative pain and microbial reduction. Triple antibiotic paste produced significantly greater pain reduction at 24, 48 and 72 hours (p=0.01, 0.002 and 0.01) and greater microbial reduction (99.1% vs. 96.8%; p=0.001) than calcium hydroxide. Both medicaments were effective, but triple antibiotic paste provided superior antimicrobial activity and faster pain relief against persistent endodontic infection. Thus, data shows triple antibiotic paste as an effective intracanal medicament while emphasizing individualized selection based on clinical needs and potential risks such as tooth discoloration and antibiotic resistance.