AIM To evaluate the antimicrobial effectiveness of Ca(OH)2 paste combined with Ibuprofen or Ciprofloxacin in infected root canals of teeth with asymptomatic apical periodontitis. METHODOLOGY Forty-five patients were randomly divided into three groups using a web programme according to the medication selected: Ca(OH)2 : 1 g Ca(OH)2 powder with 1 mL propylene glycol, Ca(OH)2 + Ibuprofen: 50 mg of Ibuprofen was added into 950 mg Ca(OH)2 powder and mixed with 1 mL propylene glycol, Ca(OH)2 + Ciprofloxacin: 50 mg of Ciprofloxacin was added into 950 mg Ca(OH)2 powder and mixed with 1 mL propylene glycol. Root canal bacteriological samples were collected before root canal treatment (S1) and after chemo-mechanical procedures (S2). After root canal preparation, the intracanal medicaments were placed into the root canals to a level approximately 1 mm short of the working length using K-files and access cavities were filled temporarily. The participants were scheduled for a second visit 7 days later when the medication was removed mechanically, and after irrigation of the root canals, the final samples (S3) were collected. Samples were subjected to quantitative real-time polymerase chain reaction to evaluate the numbers of total bacteria, Enterococcus faecalis and Streptococcus species. For intragroup analysis, a Friedman test was used to compare reduction of counts of total bacteria, Streptococci and E. faecalis amongst the three samples (S1, S2 and S3). The chi-square test was used to compare the number of root canals positive for bacteria in S1, S2 and S3 amongst the groups. RESULTS Intragroup analysis revealed a significant reduction in the number of intracanal bacterial cells from S1 to S2 and from S2 to S3 in all medication groups (P < 0.01). Although there was no significant difference amongst the groups when comparing quantitative S1 or S2 data, there were significantly lower bacterial counts in the Ca(OH)2 + Ciprofloxacin group (0.49 × 102 ) than the pure Ca(OH)2 (1.25 × 102 ) and Ca(OH)2 + Ibuprofen groups (0.76 × 102 ) at S3. The percentage reduction from S1 to S3 and from S2 to S3 was significantly greater in the Ca(OH)2 + Ciprofloxacin than the pure Ca(OH)2 and Ca(OH)2 + Ibuprofen groups (P < 0.05). In the Ca(OH)2 + Ciprofloxacin group, there were significantly fewer positive cases (8/15) than the pure Ca(OH)2 (13/15) and Ca(OH)2 + Ibuprofen (13/15) groups (P < 0.05). CONCLUSION The addition of Ciprofloxacin to Ca(OH)2 provided further antibacterial effectiveness when used as an intracanal medicament in vivo during root canal treatment.

中文翻译：

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氢氧化钙单独或与布洛芬和环丙沙星联合用于无症状根尖周炎牙齿的抗菌效果：一项随机对照临床研究。

目的评价Ca(OH)2糊剂联合布洛芬或环丙沙星对无症状根尖周炎牙根管感染的抗菌效果。方法 45 名患者使用网络程序根据所选药物随机分为三组：Ca(OH)2：1 g Ca(OH)2 粉末与 1 mL 丙二醇，Ca(OH)2 + 布洛芬：50将 mg 布洛芬添加到 950 mg Ca(OH)2 粉末中并与 1 mL 丙二醇混合，Ca(OH)2 + 环丙沙星：将 50 mg 环丙沙星添加到 950 mg Ca(OH)2 粉末中并与 1 mL 混合丙二醇。在根管治疗（S1）和化学机械程序（S2）之后收集根管细菌学样本。根管预备后，使用 K 锉将根管内药物放入根管至距离工作长度约 1 mm 的水平，并临时填充进入腔。参与者被安排在 7 天后进行第二次就诊，此时药物被机械去除，并在根管冲洗后收集最终样本 (S3)。对样品进行定量实时聚合酶链反应以评估总细菌、粪肠球菌和链球菌种类的数量。对于组内分析，弗里德曼检验用于比较三个样本（S1、S2 和 S3）中总细菌、链球菌和粪肠球菌计数的减少。卡方检验用于比较各组间S1、S2和S3细菌阳性根管数量。结果 组内分析显示，所有药物组的管内细菌细胞数量从 S1 到 S2 和从 S2 到 S3 显着减少（P < 0.01）。虽然在比较定量 S1 或 S2 数据时各组之间没有显着差异，但 Ca(OH)2 + 环丙沙星组的细菌计数 (0.49 × 102 ) 明显低于纯 Ca(OH)2 (1.25 × 102) ) 和 Ca(OH)2 + 布洛芬基团 (0.76 × 102 ) 在 S3。Ca(OH)2 + 环丙沙星组从 S1 到 S3 和从 S2 到 S3 的百分比减少显着大于纯 Ca(OH)2 和 Ca(OH)2 + 布洛芬组 (P < 0.05)。在 Ca(OH)2 + 环丙沙星组中，阳性病例 (8/15) 明显少于纯 Ca(OH)2 (13/15) 和 Ca(OH)2 + 布洛芬 (13/15) 组（ P < 0.05)。