Effect of calcium hydroxide combinations as intracanal medicament for managing post-operative pain in symptomatic apical periodontitis cases: A randomized double blinded study

• Author Details:   
• Rohit Kochhar
• Anneysha Bhattacharyya1 ^*
• Manju Kumari
• Mansi Punjabi

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Introduction: Postoperative pain is a frequent challenge in root canal treatment. alleviation of pain during endodontic procedure can be achieved using intracanal medications with combinations. Calcium hydroxide (Ca(OH)₂) is an effective intracanal medicament, and its performance depends on the vehicle used. alleviation of pain during endodontic procedure can be achieved using intracanal medications with combinations.

Aim & Objective: This study aims to compare the pain-relieving effectiveness of calcium hydroxide (CH) when combined with normal saline, lidocaine, and dexamethasone.

Methods and Materials: 45 patients diagnosed with irreversible pulpitis and symptomatic apical periodontitis in mandibular molars having pain score greater than 50 on visual analogue scale (VAS) of 100 mm were included. After preparing the root canals, the patients were randomly assigned to one of three groups with the help of scientific random number table. (n=15 in each group): Group A: CH mixed with saline, Group B: CH with lidocaine Hydrochloride and Group C: CH mixed with saline. Postoperative spontaneous pain levels were recorded daily for one week using the VAS. Statistical analysis was performed using one-way ANOVA, chi-squared test, and Mann-Whitney U tests, with a significance level set at p = 0.05.

Results: Calcium hydroxide with lidocaine HCl experienced significantly less pain compared to the other groups during the first three days (p < 0.05). However, after one week, there were no significant differences in postoperative percussion pain levels between the three groups (p > 0.05).

Conclusion: The combination of calcium hydroxide and lidocaine may be an effective combination for alleviating pain during root canal treatment.

Key message: The study demonstrates that the use of calcium hydroxide combinations as an intracanal medicament significantly reduces post-operative pain in patients with symptomatic apical periodontitis, providing an effective treatment option for managing pain after endodontic procedures.