The goal of this randomized clinical trial is to evaluate the Postoperative Pain and Flare-Up incidence following the use of Bio-Ceramic Based Intra-Canal Medication in Diabetic type II Patients compared to the Calcium Hydroxide based Intra-canal medicament.

The main questions it aims to answer are:

1. Is there any difference between using the two intracanal medicaments in the aspects of postoperative pain and flare-up incidence in diabetic type II patients?
2. Do intracanal medications reduce postoperative pain and flare-up incidence in diabetic type II patients?

Participants will be divided into two groups:

( both groups will receive root canal treatment in single rooted teeth) then: First group: will receive "Calcium Hydroxide based" intracanal medicament Second group: will receive "Bio-Ceramic Based" intracanal medicament

Postoperative pain will be assessed using:

• visual analog scale (VAS), A scale from (0 to 10) where "0" means no pain and "10" means a severe pain that has never faced before.
• Patients will be contacted by phone at 6, 12, 24, 48, 72 hours and 7 days after the first visit to collect the postoperative pain data.

Flare-up is assessed:

- by asking the patient to notify the investigator if any sudden severe pain or swelling takes place.

Inclusion Criteria:

• Patients with controlled diabetes mellitus type II.

• Necrotic single rooted teeth:

  • with periapical lesion ranging (1-2mm) in diameter.
  • with complete root formation.
  • Without calcified root canals.
  • Without root caries.
  • Without external or internal root resorption.
  • Without anatomical abnormalities such as fusion.

Exclusion Criteria:

• Pregnant females.
• Patients with other systemic diseases in combination with diabetes mellitus.
• Patients under antibiotic or analgesic administration.
• Patients with facial swelling.
• Teeth that are not indicated for endodontic treatment: bad oral hygiene, mobile teeth, or recessed teeth.
• Previously endodontically treated teeth.
• Teeth with sinus tract.

Individual Participant Data (IPD) will not be shared due to privacy concerns and the limited scope of data use approved by the ethics committee. The study is designed for internal analysis only and does not include provisions for public data sharing.

Participants will be blinded to the type of intracanal medicament used during their root canal treatment. The medicaments will be applied in a manner that prevents participants from identifying which treatment they received.