Effect of tricalcium silicate-based intracanal dressing on antibacterial-antifungal activity and postoperative pain intensity after non-surgical endodontic retreatment: randomized controlled clinical trial.

OBJECTIVES

This study aimed to evaluate the antibacterial and antifungal efficacy, as well as postoperative pain levels, following non-surgical retreatment of single-rooted teeth using tricalcium silicate- or calcium hydroxide-based intracanal dressings.

MATERIALS AND

METHODS

Forty-nine patients diagnosed with apical periodontitis were randomly assigned to two groups: tricalcium silicate (n = 25) and calcium hydroxide (n = 24). Microbiological samples were obtained before instrumentation (S1), after chemo-mechanical preparation (S2), and 10 days post-medication (S3). Total bacterial load and Candida albicans levels were quantified using qPCR. Postoperative pain was assessed on days 1, 3, 5, 7, and 10.

RESULTS

No significant differences were found between the groups in demographic variables. The calcium hydroxide group showed a significantly greater reduction in total bacterial load in S3 samples. No significant differences were observed between groups regarding C. albicans levels or postoperative pain at any time point. However, a significant reduction in pain was noted on day 1 compared to baseline in the calcium hydroxide group.

CONCLUSIONS

Both materials were effective in reducing microbial load; however, calcium hydroxide demonstrated superior antibacterial efficacy. Antifungal activity and postoperative pain outcomes were comparable between the groups.

TRIAL REGISTRATION: This trial was registered at Clinicaltrials.gov on 15/01/2025 (NCT06779370).