Cavit

The root canal was obturated with gutta-percha cones (Dentsply Sirona, USA) and AH-Plus sealer (Dentsply, DeTrey, Konstanz, Germany) using the cold lateral compaction technique. The quality of the obturation was evaluated by buccolingual and mesiodistal radiographs. Cavit (3M ESPE, Germany) was placed in the access, and the samples were stored at 37°C and 100% relative humidity for 30 days.

The 76 teeth were randomly allocated into 4 groups (n = 19), depending on medicament used:

Group-1 – Ibuprofen (≥98% pure powder) (Sigma–Aldrich, India) + distilled water (1:1 w/v)

Group-2 – Diclofenac sodium salt (Sigma-Aldrich, India) + distilled water (1:1 w/v)

Group-3 – Ca(OH)₂ powder (Deepashree Products, Rathnagiri, India) + distilled water (1:1 w/v)

Control: No medicament.

Intracanal medicaments were prepared on sterile glass slab by mixing test material with distilled water to obtain a creamy mix. Test medicaments were then placed into root canals with lentulo spiral placed up to working length. Root canal orifices (including control group) were plugged with cotton pellet, sealed with temporary restoration (Cavit, 3M ESPE, Germany), and kept in incubator (Confident Dental Equipments Pvt. Ltd., India) at 37°C for 7 days.

Handling of MTA was performed according to the manufacturers’ instructions. A metal spatula was used for mixing one sachet of MTA with one drop of distilled water on a sterile glass slab. After 30 seconds of mixing, the mixture was homogeneous with a consistency similar to wet sand. The mix was carried and condensed using a finger plugger, lightly with a moistened sterile cotton pellet to ensure a thickness of 3–4 mm in the apical end of the root canal. All recommendations of the manufacturer were followed. After the MTA was condensed, excess MTA on the canal walls was gently wiped with moist cotton. Another moist cotton pellet was placed over it and the canal was sealed with a temporary restoration (Cavit, 3M ESPE, Seefeld, Germany). Placement of MTA at the apex was confirmed radiographically.
The patient was advised to avoid food and drinks for 1 hour to ensure the setting of temporary restoration. The patient was recalled after 24 hours.

180 specimens were allocated to the following three groups:
Group I: Triple Antibiotic Paste (TAP); Group II: Calcium hydroxide paste (Apexcal); Group III: Ledermix
Group I: Triple Antibiotic Paste (TAP)
1st experimental group (n = 60), For the preparation of TAP, 1mg / ml of each antibiotic powders (USP-grade) in equal quantities of metronidazole, ciprofloxacin and minocycline in a ratio of 3:1 was combined with polyethylene glycol. A sterile lentulo spiral was used for the introduction of the prepared medicament into the root canals with a slow-speed handpiece. Following this, the medicament was compacted to the level of the CEJ using sterile pluggers (Sybron endo).
Group II: Calcium hydroxide paste (Apexcal)
For the second experimental group (n = 60), commercially available Ca (OH) 2 paste (Apexcal) was used. The medicament application to the root canal space was done in a similar manner as described previously.
Group III: Ledermix
For the third experimental group (n = 60), commercially available Ledermix paste was used. The paste was introduced into the root canals as elaborated previously. Following medicament application, 4mm of cavit (3M ESPE) was used to seal all the prepared specimens. After the coronal seal was achieved, flowable composite (Ivoclar Vivadent) was used to obtain an apical seal.