Triple antibiotic paste versus nano calcium hydroxide as an intracanal medicament in human primary molars: a randomized clinical trial

Aim: Intracanal medicaments play a critical role in cleaning microbial biofilm, dentin tubule sterilization, and successful endodontic treatment. This study aimed to evaluate the antibacterial effect of Nano-calcium hydroxide (NCH) and Triple Antibiotic Paste (TAP) as intra-canal medicaments in human non-vital primary molar teeth. Methodology: The NCH particles were characterized by transmission electron microscopy (TEM), Fourier transform infrared (FTIR) spectroscopy, and X-ray diffraction (XRD). This study included 39 primary molar teeth with an indication for non-vital pulp therapy. Following the access cavity preparation, a microbial sample (S 1) of each tooth was collected and canals were prepared by chemo-mechanical technique. Using dynamic block randomization, canals were divided into three groups based on the type of medicament. The second microbial sample (S 2) was collected 7 days after ICM application. The canal's aerobic and anaerobic micro-organisms load was calculated by counting colony-forming units (CFUs). Results: The TEM, FTIR, and XRD characterization techniques confirm the NCH nanoparticle formation. NCH showed a reduction of the number of aerobic and anaerobic micro-organisms by 98.09% and 90.79%, respectively. While TAP had greater antibacterial activity compared to NCH aerobic (99.95%) and anaerobic (99.78%) micro-organisms. NCH and TAP showed a statistically significant difference (P<0.005) in bacterial elimination of the root canals in comparison with chemo-mechanical irrigation alone. Conclusion: Both TAP and NCH antibacterial activity were approved during the endodontic.