Comparative Evaluation of the Effect of Two Different Types of Calcium Hydroxide on Periapical Granulomas: A Randomized Controlled Trial
DOI:
https://doi.org/10.61172/qmvsj406Keywords:
Calcium Hydroxide, Periapical Granuloma, Root Canal TherapyAbstract
Objective The mere surgical removal of periapical granulomas through root-end surgery, without proper biomechanical preparation of the canal, placement of calcium hydroxide intracanal medicament, and obturation, does not result in the desired healing of periradicular tissues. The objective of this study was to determine the difference between injectable calcium hydroxide and powder/liquid calcium hydroxide in the resolution of pain (using the Numerical Pain Rating Scale) and periapical granulomas through periodic assessment and measurement of periapical radiolucency, radiographically and using periapical index (PAI) scores.
Methods This six-month randomized controlled trial was conducted at the Restorative Unit of the National Hospital, Abuja, from 9 August 2018 to 10 February 2020. A total of 128 participants with 128 maxillary anterior teeth presenting with periapical granulomas and a PAI score of ≥4 with horizontal diameter ≥5 mm were recruited. They were randomly assigned to two groups: Group A (n=64) received proprietary injectable calcium hydroxide (Calasept), while Group B (n=64) received the powder/liquid mixture. Participants were recalled at 1 week post-treatment and then monthly for 6 months. Healing was assessed using periapical radiographs and PAI scores. Canals were redressed at 3 months. The primary outcome was lesion size reduction in millimeters and PAI score changes; the secondary outcome was pain resolution. Statistical analysis was performed using Student's t-test, regression analysis, and Friedman test with IBM SPSS version 20.0. A p-value < 0.05 was considered significant.
Results At 6 months, 100% of participants in both groups had resolution of pain symptoms. Both groups showed significant reduction in periapical lesion size from month 2 to month 6, with faster resolution in Group A. PAI scores significantly reduced in both groups at 6 months, with comparable scores throughout (P < 0.05).
Conclusion The findings suggest that both preparations of calcium hydroxide are effective, but the injectable form (Calasept) promotes faster resolution of lesions and symptoms.
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