Comparative Evaluation of Calcium Hydroxide, Triple Antibiotic Paste, and Nanosilica-Enhanced Tri Antibiotic Paste for Root Canal Disinfection in Periapical Lesions

Abstract

Background: Periapical lesions are typical pathologic processes occurring in periapical tissues of teeth and are
commonly caused by bacterial infections as a result of pulpal necrosis. The appropriate diagnosis and treatment
play an important role in maintaining the structure of the teeth and avoiding complications. Aims: The purpose of
this study is to examine the effectiveness of Calcium hydroxide paste, Triple antibiotic paste (TAP), and nanosilica
TAP (NTAP) as a root canal disinfectant in treating periapical lesions. Materials and Methods: A randomized
controlled trial was carried out on 60 patients aged 15–45 years old with periapical lesions in maxillary anterior
teeth, split into 3 groups: Calcium hydroxide paste, TAP, and NTAP. Both clinically and radiographically, the
periapical index (PAI) was recorded at 3, 6, 12, and 18 months after endodontic evaluation. Results: PAI was
discovered to exhibit no significant differences between scores 5 at baseline and at 3 months but significant
differences at 6 months with 80% of the samples in the NTAP group achieving PAI score of 3 (P = 0.029) and
90% of the samples in the TAP group achieving a PAI score of 3 at 12 months. Calcium hydroxide (20%) and TAP
(10%) showed failures but the NTAP group showed efficiency. Conclusion: NTAP has already been shown to be a
successful root canal disinfectant in the treatment of periapical lesions without failures by lowering the PAI score.
Periapical lesions can be treated successfully with early diagnosis and proper management. Although traditional
root canal treatment is the norm, there are new regenerative methods that have the potential to save dentures.