Postoperative Pain Following Intracanal Medications with 0.2% Cetrimide Gel Compared to Calcium Hydroxide in Patients with Symptomatic Apical Periodontitis: A Double Blind Randomized Clinical Trial

Abstract

A randomized clinical trial to assess the efficacy of cetrimide Gel 0.2 % and calcium hydroxide when used as intracanal medication between visits on postoperative pain in patients with necrotic pulp and symptomatic apical periodontitis in mandibular posterior teeth . Forty six participants diagnosed with necrotic pulp and symptomatic apical periodontitis in mandibular posterior teeth were randomly assigned into two equal groups, according to intracanal medication used, either 0.2 % cetermide or calcium hydroxide. Root canal performed in two visits as followed steps, first visit was access cavity, rubber dam application, working length determination, chemo mechanical preparation with protaper universal rotary system and NaOcl 2.6 % irrigation with EDTA 17 % as final flush then application of intracanal medication as randomly assigned. Postoperative pain recorded with Visual analogue scale at different time follow up 4,24,48,72 hours, 4, 5, 6 and 7 days then second visit after one week , access opened and obturation was done with modified single cone technique with a resin sealer. Results showed there was no statistical significance between two groups, group A (cetrimide) and groups B (calcium hydroxide) in postoperative pain. Only group A (cetrimide) showed significant decrease in pain at 48 hours follow up than group B (calcium hydroxide) at 72 hours follow up. For analgesic taken during follow up and incidence of swelling no statistically significant difference between two groups. Further analysis for Age range, gender, tooth type showed no statistically significant between two groups, group A (cetrimide) and groups B (calcium hydroxide) in postoperative pain. Recommendation