Comparative Evaluation of the Effects of Calcium Hydroxide and BIO-C Temp Medicaments on Postoperative Pain in Patients Undergoing Endodontic Treatment: a Clinical Study

This clinical study is a comparative investigation designed to evaluate interappointment postoperative pain in patients undergoing multi-visit endodontic retreatment. Postoperative pain is a frequent concern in endodontic practice and may affect patient comfort, treatment compliance, and overall satisfaction. The study focuses on whether the choice of intracanal medicament used between treatment sessions influences postoperative pain levels and patient-reported outcomes.

Study Design

The study is conducted as a clinical, comparative study involving patients who require multi-visit endodontic retreatment of single-rooted teeth. Following the initial treatment session, eligible patients are assigned to receive one of two intracanal medicaments during the interappointment period.

Participants

Patients included in the study are systemically healthy individuals classified as ASA Physical Status I, presenting with single-rooted teeth requiring endodontic retreatment and exhibiting normal root anatomy. Patients with conditions or factors that could influence pain perception or treatment outcomes are excluded. All participants provide informed consent prior to enrollment.

Interventions

After completion of the initial endodontic retreatment procedures, intracanal medicaments are placed between treatment sessions. Patients receive either calcium hydroxide, a conventional intracanal medicament, or Bio-C Temp, a newer bioceramic-based intracanal medicament proposed as an alternative to traditional materials. The assigned medicament remains in the root canal system throughout the interappointment period until the subsequent treatment session.

Follow-up and Pain Assessment

Postoperative pain is assessed during the interappointment period using standardized pain assessment tools. Patients are asked to record their pain intensity at predefined time points following the initial treatment session, specifically at 12 hours, 24 hours, 3 days, 5 days, and 7 days. Pain intensity is evaluated using validated pain rating scales, such as the Visual Analog Scale or Numerical Rating Scale.

In addition to pain intensity, patients are monitored for analgesic consumption during the interappointment period. Information regarding the use of pain-relieving medications is recorded at the same follow-up time points.

Outcome Measures

The primary outcome measure of the study is interappointment postoperative pain intensity associated with each intracanal medicament. According to the clinical protocol, a standard-dose analgesic will be prescribed to all participants for postoperative pain control (for example, ibuprofen 400-600 mg to be taken as needed, no more often than every 4-6 hours). Analgesic use will be entirely determined by pain levels, and the number of tablets taken will be documented as a secondary outcome measure.

Study Objective

The primary objective of this study is to compare the effects of calcium hydroxide and Bio-C Temp on interappointment postoperative pain in multi-visit endodontic retreatment. By comparing a conventional intracanal medicament with a newer bioceramic-based alternative, the study aims to provide clinically relevant information that may assist clinicians in selecting intracanal medicaments and improving pain management strategies in endodontic practice.

Inclusion criteria

• • Patients with single-rooted teeth requiring endodontic retreatment.

• Individuals in good general health, classified as ASA Physical Status I.
• Teeth presenting normal anatomical structure and root morphology.

Exclusion criteria

• • Patients who have used antibiotics or analgesic medications within the last month.

• Pregnant individuals and patients with systemic diseases (such as chronic illnesses, diabetes mellitus, hypertension).
• Teeth with root fractures or perforations.
• Teeth with complex root canal anatomy, multirooted teeth, or severely curved roots.
• Patients presenting with high baseline pain levels, particularly those with a history of treatment-resistant pain.