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: 1. Clinical success in terms of absence of any complication such as spontaneous pain, sinus or swelling. 2. Radiographic success in terms of healing of periapical radiolucency or increase root thickness, length or apical closure.
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
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
40
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
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
absence of postoperative pain
binary question by asking patients (yes or no)
Time frame: immediate post operative
absence of postoperative pain
binary question by asking patients (yes or no)
Time frame: at 3 months follow up
absence of postoperative pain
binary question by asking patients (yes or no)
Time frame: at 6 months follow up
absence of postoperative pain
binary question by asking patients (yes or no)
Time frame: at 9 months follow up
absence of postoperative pain
binary question by asking patients (yes or no)
Time frame: at 12 months follow up
healing of sinus
Clinical success in term of absence of sinus (Yes or No)
Time frame: 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)
Time frame: 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)
Time frame: baseline, 6 months, 12 months
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change in root length
Radiographic evaluation by calibration of root length in millimetre by Digora
Time frame: baseline, 6 months, 12 months
change in dentin root thickness
Radiographic evaluation by calibration of root thickness in millimetre by Digora
Time frame: baseline, 6 months, 12 months
change in apical diameter
Radiographic evaluation by calibration of apical diameter in millimetre by Digora
Time frame: baseline, 6 months, 12 months