Evaluation of Postoperative Pain and Bacterial Load Reduction With ProTaper Ultimate Versus ProTaper Gold Rotary Systems

Evaluation of Postoperative Pain and Bacterial Load Reduction After Canal Preparation With ProTaper Ultimate Versus ProTaper Gold Rotary Systems in Patients With Necrotic Maxillary Premolars (Randomized Clinical Trial)

This study aims to research the effect of different instrument designs by comparing protaper ultimate versus protaper gold systems on root canal preparation by evaluating bacterial count reduction and post-operative pain following single visit treatment in patients with necrotic pulp in maxillary premolar teeth.

Inclusion Criteria:

• Patient's age ranges between 22 to 45 years with no sex predilection.

• Medically free patients.

• Maxillary permanent premolar teeth:

  • Diagnosed clinically with pulp necrosis.
  • Absence of pain.
  • Radiographic evidence of two roots or single root with double canals.
  • Slight widening in the periodontal membrane space or with peri-apical radiolucency
  • No response to cold pulp tester and ethyl chloride spray.

• Patients who can understand Modified Visual Analogue Scale (VAS).

• Patients' acceptance to participate in the trial.

Exclusion Criteria:

• Medically compromised patients.

• Pregnant women.

• If analgesics or antibiotics have been administrated by the patient during the past 24 hours preoperatively.

• Patients reporting bruxism or clenching.

• Teeth with:

  i. Vital teeth. ii. Single canal maxillary premolar teeth iii. Association with swelling or fistulous tract. iv. Acute peri-apical abscess and swelling. v. Mobility Grade II or III. vi. Pocket depth more than 5mm. vii. Previous root canal therapy. viii. Non-restorable teeth: Hopeless tooth

• Immature teeth.

• Radiographic evidence of external or internal root resorption vertical root fracture, perforation, calcification, root caries.