Effects of Chlorhexidine-Metronidazole Combination as an Intracanal Medicament on Periodontal Healing in Concurrent Endodontic Periodontal Lesions With Communication: A Randomized Controlled Clinical Study
试验速览
- 阶段
- 不适用
- 入组人数
- 36
- 主要终点
- PPD
研究概览
简要总结
Considering the beneficiary properties of both Chlorhexidine (CHX) and Metronidazole (MTZ) such as property of substantivity and diffusion of these drugs on the external surfaces through the anatomical communication channels in between the root canals and periodontium, may be utilized as an alternative approach for the delivery of drug ( intracanal medicament) in the deep periodontal pockets in concurrent endodontic- periodontic lesion with communication lesions. Thus the aim of study is to conduct a prospective randomized controlled clinical trial to evaluate and compare the effects of CHX-MTZ combination with chlorhexidine alone as an intracanal medicament on periodontal healing in concurrent endodontic- periodontic lesion with communication.
详细描述
INTRODUCTION
The pulp tissue within the tooth and surrounding periodontium are interrelated to each other due to structural, functional and microbiological similarities. Cross infection of bacterial colonies take place in between these sites through dentinal tubules, apical foramen, lateral and accessory canals.Concurrent endodontic- periodontic lesions are those lesions where both endodontic and periodontal diseases occurring at same time in relation to single tooth.
Endodontic infection present in tooth is responsible for more bone loss, attachment loss and results in impaired healing of periodontium and vice versa.
Complete elimination of microorganisms from infected root canal is very challenging and complicated task. It has been reported that bacteria may survive within the root canal even after chemomechanical preparation, these remaining bacteria again multiply within the root canal. So, intracanal medicament is used as an adjunct to mechanical preparation in disinfection of root canal system.
Chlorhexidine (CHX) is widely used as an intracanal medicament because of its high antimicrobial action, against gram positive and gram negative bacteria.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 55 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Patients of age between 18-55 years with generalized chronic periodontitis will be enrolled, having at least one tooth with concurrent endodontic periodontal lesion with communication including following features:
- •a clinical and radiographic diagnosis of concurrent endodontic periodontal lesion
- •Wide base pocket, deep probing pocket depth
- •Non vital tooth on the basis of pulp sensibility tests along with periapical radiolucency
- •Radiographic alveolar bone (marginal bone) destruction with apical communication
- •Patients of generalized chronic periodontitis will be selected on the basis of Armitage classification of periodontal diseases and conditions [≥30% sites involved with clinical attachment level (CAL) 1-2mm (mild) or 3-4mm (moderate) or ≥5mm (severe)]
- •Patients should have more than 20 teeth in their oral cavity excluding third molars.
排除标准
- •Systemic illness known to affect the periodontium or outcome of periodontal therapy.
- •Patient taking medications such as corticosteroids, calcium channel blockers and anticoagulant therapy, which are known to interfere periodontal wound healing or patient on long term NSAID therapy or bisphosphonates.
- •Patients allergic to medication (chlorhexidine, local anaesthetic, antibiotics, NSAID).
- •Patients with acute symptoms.
- •Pregnant or lactating females.
- •Smokers (current and past) and tobacco chewers.
- •Grade 3 mobile teeth.
- •Unrestorable tooth.
- •Root resorption.
- •Fractured/perforated roots.
- •Developing permanent tooth.
- •Abutments.
- •Previously root canal filled tooth.
- •Patients with aggressive periodontitis
- •History of periodontal treatment within 6 months prior to study.
结局指标
主要结局
PPD
时间窗: 6 and half months
Probing pocket depth
CAL
时间窗: 6 and half months
Clinical attachment loss
次要结局
未报告次要终点