Evaluation of Post-Operative Pain Following the Use of Nano-Calcium Hydroxide

Evaluation of Post-Operative Pain Following the Use of Nano-Calcium Hydroxide as an Intracanal Medicament: A Randomized Controlled Trial

The goal of this clinical trial is to evaluate the effect of different intracanal medicaments-conventional calcium hydroxide (CH) and nano-sized calcium hydroxide (NCH)-on the intensity of postoperative pain following root canal treatment in asymptomatic necrotic single-rooted teeth.

The primary research question of this study is as follows:

Does the use of nano-sized calcium hydroxide, compared to conventional calcium hydroxide, result in significantly reduced postoperative pain after root canal treatment?

In both groups, standardized instrumentation will be performed using rotary NiTi files and 2.5% sodium hypochlorite irrigation. After cleaning and shaping, canals will be medicated with either CH or NCH, followed by temporary sealing.

Inclusion Criteria:

• Patients aged 18-65 years
• Single-rooted permanent maxillary or mandibular teeth
• Asymptomatic teeth with necrotic pulps confirmed by negative response to cold test
• Presence of periapical radiolucency (PAI score 2-5)
• No sensitivity to percussion or palpation
• Patients who signed informed consent

Exclusion Criteria:

• Pregnancy or lactation
• Systemic diseases requiring antibiotic prophylaxis (e.g., infective endocarditis, immunosuppression)
• Use of antibiotics, corticosteroids, or analgesics within the past 7 days
• History of chemotherapy or radiotherapy
• Uncontrolled diabetes mellitus or hypertension
• Chronic renal failure, hematologic disorders
• Teeth with root resorption, previous endodontic treatment, or multirooted anatomy
• Teeth with periodontal pockets >4 mm or mobility
• Inability to attend follow-up visits
• Patients with extensive coronal destruction rendering definitive restoration unfeasible