Methods: Clindamycin-EVA fibers with sustained release properties were produced by extrusion. Fifty-six patients requiring root canal therapy on single rooted teeth were treated by standard chemi-mechanical debridement, and were randomly assigned to three intracanal medicament groups: (1)) EVA fiber alone (negative control); (2) Ca(OH)2paste; (3) clindamycin-EVA fiber. Patients were recalled after 7 days, the medicaments were removed, canals irrigated, dried and resealed with no medicament. After an additional 7 days (to allow outgrowth of any residual bacteria), teeth were obturated with gutta percha (day 14). Pain to percussion or palpation, periapical tissue swelling, and bacterial growth were evaluated prior to treatment, and after 7 and 14 days.
Results: At presentation, all root canals were positive for bacterial growth. Percussion sensitivity pre- treatment vs 14 day recall was: 8/19 vs 6/19 for the EVA only control group; 7/18 vs 3/18 in the Ca(OH)2 group; and 11/19 vs 0/19 for the clindamycin-EVA group. Pre-treatment vs 14 day palpation sensitivity was 12/19 vs 5/19 for EVA only controls; 13/18 vs 6/18 for Ca(OH)2; and 8/19 vs 0/19 for clindamycin-EVA. At 14 days periapical tissue swelling was present in 6/19 of EVA only controls; 3/18 Ca(OH)2; and 0/19 clindamycin-EVA. There was one flare up each in the control and Ca(OH)2 groups but none in the clindamycin-EVA group.
Conclusion: Inter-appointment treatment of endodontically-treated, infected teeth with clindamycin-EVA fibers completely eliminates pain and flare-ups.