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This study aims to compare regenerative endodontics for necrotic young permanent anterior teeth using oral photo-activated disinfection versus triple antibiotic paste in terms of:
Disinfection of the root canal system is thought to be critical to the success of Regenerative Endodontic Procedures (REPs) as infection prevents regeneration, repair and stem cell activity . A suitable material for using as intra-canal medicament seems to be antibiotic. Triple antibiotic paste (TAP) containing metronidazole, ciprofloxacin and minocycline has been reported to be a successful regimen in controlling the root canal pathogen and in managing necrotic young permanent tooth .
Recently, new disinfection methods have been developed to overcome the limitations of conventional disinfecting protocols that they may neither reduce the number of bacteria to a satisfactory level nor minimize the toxicity to periapical stem/progenitors . Other concerns regarding the use of TAP are tooth discoloration after treatment and bacterial resistance. Photo-activated oral disinfection is a novel disinfection method which present a great solution for the problem associated with triple antibiotic paste
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Photo Activated Disinfection | Experimental | Photoactivated disinfection (PAD) is based on the interaction of a photosensitive antibacterial agent and a light source. It uses a nontoxic dye [named photosensitizer PS] and low-intensity visible light. In oxygen presentation, these combine to produce some cytotoxic species. The PS molecules attach to bacteria membrane |
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| Antibiotic paste | Active Comparator | Hoshino et al. recommended a ratio of 1:1:1 of metronidazole (500 mg), minocycline (100 mg) and ciprofloxacin (200 mg) for the 3Mix formulation |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Photo Activated Disinfection | Device | Photoactivated disinfection (PAD) is based on the interaction of a photosensitive antibacterial agent and a light source. It uses a nontoxic dye [named photosensitizer PS] and low-intensity visible light. In oxygen presentation, these combine to produce some cytotoxic species. The PS molecules attach to bacteria membrane |
| Measure | Description | Time Frame |
|---|---|---|
| absence of postoperative pain | binary question by asking patients (yes or no) | immediate post operative |
| absence of postoperative pain | binary question by asking patients (yes or no) | at 3 months follow up |
| absence of postoperative pain | binary question by asking patients (yes or no) | at 6 months follow up |
| absence of postoperative pain | binary question by asking patients (yes or no) | at 9 months follow up |
| absence of postoperative pain | binary question by asking patients (yes or no) | at 12 months follow up |
| Measure | Description | Time Frame |
|---|---|---|
| healing of sinus | Clinical success in term of absence of sinus (Yes or No) | immediate post operative, 3 months, 6 months, 9 months, 12 months |
| healing of swelling | Clinical success in term of absence of swelling (Yes or No) |
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Inclusion Criteria:
Exclusion Criteria:
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| ID | Term |
|---|---|
| D003790 | Dental Pulp Necrosis |
| ID | Term |
|---|---|
| D003788 | Dental Pulp Diseases |
| D014076 | Tooth Diseases |
| D009057 | Stomatognathic Diseases |
| D009336 | Necrosis |
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| ID | Term |
|---|---|
| D010778 | Photochemotherapy |
| ID | Term |
|---|---|
| D003131 | Combined Modality Therapy |
| D013812 | Therapeutics |
| D004358 | Drug Therapy |
| D010789 | Phototherapy |
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| antibiotic paste | Drug | An antibiotic mixture composed of ciprofloxacin, metronidazole, and minocycline, known as triple antibiotic paste (TAP) or "3mix", has been the most widely used medicament, This goes back to the studies by Hoshino et al.1996 |
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| immediate post operative, 3 months, 6 months, 9 months, 12 months |
| healing of periapical radiolucency | Radiographic success in term of healing of periapical or radiolucency (Yes or No) | baseline, 6 months, 12 months |
| change in root length | Radiographic evaluation by calibration of root length in millimetre by Digora | baseline, 6 months, 12 months |
| change in dentin root thickness | Radiographic evaluation by calibration of root thickness in millimetre by Digora | baseline, 6 months, 12 months |
| change in apical diameter | Radiographic evaluation by calibration of apical diameter in millimetre by Digora | baseline, 6 months, 12 months |
| D010335 |
| Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |