Efficacy of different endodontic irrigants in the lesion sterilization and tissue repair technique in primary molars: A randomized controlled clinical trial

This study aims to evaluate the efficacy of different endodontic irrigants employed in the lesion sterilization and tissue repair (LSTR) technique. Forty children aged 4-8 years having at least one primary molar with irreversible pulpitis/pulpal necrosis indicated for pulpectomy were included. Participants were randomly divided into three test groups (Group A, B, and C) and one control group (Group D). After caries excavation using a spoon excavator, superficial pulp was removed under topical anesthesia in all groups. Following this, pulpal floor was irrigated using different endodontic irrigants in each group: Group A - 20% propolis, Group B - 2% sodium hypochlorite, Group C - 2% chlorhexidine gluconate, and Group D (control) - saline. Alternate 3-Mix (triple antibiotic paste containing metronidazole, ciprofloxacin, and amoxicillin) was then placed over the pulpal floor and the teeth were restored with glass ionomer cement followed by stainless steel crown. Patients were recalled at follow-up periods up to 18 months for clinical and radiographic evaluation. Repeated-measures ANOVA test, Chi-square test, and independent t-test were used for statistical analysis. Clinical success was achieved in all treated teeth, with the results showing statistical significance (P < 0.05). In addition, Group C showed best clinical results. Statistically significant results (P < 0.05) were obtained in reduction in size of furcation radiolucency, with Group B showing the best results compared to other groups. Statistically significant results (P < 0.05) were obtained in terms of rate of root resorption in all teeth, with Group C showing least resorption compared to other groups. The use of endodontic irrigant before the placement of alternate 3-Mix is an effective step for the improved success of LSTR technique in primary teeth, with chlorhexidine showing the best success rate.