{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T10:04:36Z","timestamp":1782468276303,"version":"3.54.5"},"reference-count":23,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007607","name":"University Research Council, Aga Khan University","doi-asserted-by":"publisher","award":["70353"],"award-info":[{"award-number":["70353"]}],"id":[{"id":"10.13039\/100007607","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,7,6]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Various intracanal medicaments have been used in cases of chronic apical periodontitis for appropriate disinfection of the root canal system to eliminate microbes especially from the inaccessible areas. Calcium hydroxide is the most common intracanal medicament available in various forms, but its effectiveness with or without iodoform using microbial culture is unknown. Therefore, our aim is to compare the antimicrobial efficacy of Calcipex and Metapex in endodontic treatment of teeth presenting with chronic apical periodontitis by assessing the bacterial load reduction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method and analysis<\/jats:title>\n                  <jats:p>60 single rooted teeth of patients with diagnosis of chronic apical periodontitis will be selected and the canals debrided chemomechanically. The patients will be randomised into two groups: Calcipex and Metapex. The first sample (S1) for bacterial culture will be taken before placement of intracanal medicament and the second sample (S2) will be taken after 7\u2009days, before final obturation from the canal and sent to lab for culture. Colony-forming unit will be evaluated. Paired t-test will be used to assess difference between antimicrobial efficacies within the group of medicaments. Independent sample t-test will be used to assess antimicrobial efficacies between groups. Level of significance will be kept at 0.05.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Approval from Aga Khan University Hospital Ethical review committee is taken. Findings will be reported according to the Standard Protocol Items for Randomised Trials guidelines. Research findings will be disseminated through annual reports, peer-reviewed journals and conferences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04336709\">NCT04336709<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-048947","type":"journal-article","created":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T13:06:02Z","timestamp":1626872762000},"page":"e048947","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Comparison of antimicrobial efficacy of Calcipex and Metapex in endodontic treatment of chronic apical periodontitis: a randomised controlled trial study protocol"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct04336709","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2335-4728","authenticated-orcid":false,"given":"Momina Anis","family":"Motiwala","sequence":"first","affiliation":[{"name":"Operative Dentistry, Surgery, The Aga Khan University Hospital Main Campus, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saqib","family":"Habib","sequence":"additional","affiliation":[{"name":"Operative Dentistry, Surgery, The Aga Khan University Hospital Main Campus, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robia","family":"Ghafoor","sequence":"additional","affiliation":[{"name":"Operative Dentistry, Surgery, The Aga Khan University Hospital Main Campus, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Irfan","sequence":"additional","affiliation":[{"name":"Pathology and laboratory medicine, The Aga Khan University Hospital Main Campus, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,21]]},"reference":[{"key":"2025101812570354000_11.7.e048947.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-302X.2005.00227.x"},{"key":"2025101812570354000_11.7.e048947.2","first-page":"119","article-title":"Success rate of nonsurgical endodontic treatment of nonvital teeth with variable periradicular lesions","volume":"6","author":"Moazami","year":"2011","journal-title":"Iran Endod J"},{"key":"2025101812570354000_11.7.e048947.3","first-page":"195","article-title":"Antimicrobial effects of four intracanal medicaments on Enterococcus faecalis: an in vitro study","volume":"9","author":"Mozayeni","year":"2014","journal-title":"Iran Endod J"},{"key":"2025101812570354000_11.7.e048947.4","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.joen.2007.11.015","article-title":"Quantification of endotoxins and cultivable bacteria in root canal infection before and after chemomechanical preparation with 2.5% sodium hypochlorite","volume":"34","author":"Martinho","year":"2008","journal-title":"J Endod"},{"key":"2025101812570354000_11.7.e048947.5","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4103\/1658-5984.155450","article-title":"Histological evaluation of the root apices of failed endodontic cases","volume":"5","author":"Pecora","year":"2015","journal-title":"Saudi Endod J"},{"key":"2025101812570354000_11.7.e048947.6","unstructured":"Tanumihardja MWS , Pattelongi IJ , Samad R , et al . 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