Assessment of Postoperative Pain After Using Various Intracanal Medication in Patients With Necrotic Pulp

When the treatment itself appears to initiate the onset of pain and/or swelling, the result can be very distressing to both the patient and the operator. Patients might even consider postoperative pain and flare-up as a benchmark against which the clinician's skills are measured. Prevalence of postoperative pain or flare-up is, therefore, one of the influencing factors when making a clinical decision. Better management of postoperative pain increases the patients' confidence in dentist's skills and gives positive attitude toward dental profession. In cases with necrotic pulp, the incidence of pain becomes higher, hence testing which intracanal medication is more effective in decreasing the bacteria present within the root canal and subsequently pain is crucial.

Inclusion criteria

• Patients who are free from any physical or mental handicapping condition with no underlying systemic disease.
• Non-pregnant females
• Asymptomatic necrotic mandibular single rooted teeth.
• Normal occlusal contact with the opposing teeth.
• Patients accepting to participate in the study.

Exclusion criteria

• Medically compromised patients: Pain levels and healing following treatment would be compromised as these patients have shown higher incidence of pain and lower healing rate.
• Pregnant women: Avoid radiation exposure, anesthesia, and medication.
• If analgesics or antibiotics have been administrated by the patient during the past 12 hours preoperatively might alter their pain perception
• Patients reporting bruxism or clenching: Avoid further pressure on an already inflamed tooth inducing subsequent irritation and inflammation Teeth that shows:
• Association with acute periapical abscess and swelling: Need special treatment steps which could involve additional visits with incision and drainage. Also, it could influence initiation and progression of postoperative pain.
• Greater than grade I mobility or pocket depth greater than 5mm. Need special surgical and/or periodontal therapy.
• No restorability: Hopeless tooth.
• Vital teeth
• Immature teeth
• Radiographic evidence of external or internal root resorption.
• Any criterion, not mentioned in the inclusion criteria