Comparative Evaluation Of Post-Operative Endodontic Pain Using Various Intracanal Medicaments After Instrumentation With Rotary Single-File System.

Abstract

Aim: To compare the action of intracanal medicaments: Calcium hydroxide and 2%  Chlorhexidine,10% Metronidazole gel, Septilin, and 2% Chitosan as intracanal medicaments after instrumentation with One curve® (Micromega) Rotary Single-file System at 6hrs, 12hrs, 24hrs, 48hrs, 72hrs and one week.

Methods: A total of 50 mandibular molars were included (n=50) with occlusal caries and mild to moderate pre-operative pain with minimal periapical radiolucency. After completing access cavity preparation under local anesthesia and isolation with a rubber dam, instrumentation with One curve single file was completed and patients were divided into groups of medicaments with a group of no medicaments or only normal saline. Patients were asked for the changes in pain compared to those observed before treatment. Postoperative pain was noted and graded on the numeric scale from 0-5 and assessed as increased, decreased, constant, and no pain at the respective time intervals.

Results: In all the study groups, there was a significant decrease in postoperative pain at 6 hrs. Calcium hydroxide with 2% Chlorhexidine showed a significant decrease in postoperative pain and its efficacy was evident from 24 hrs up to 7 days. Metronidazole 10% intracanal medicament at 6 hrs and 12 hrs showed maximum pain reduction post-operatively, which had sustained effect up to 7 days. This result was statistically significant. Septilin and 2% Chitosan intracanal medicaments showed a maximum decrease in post-operative pain at 24-48 hrs, with a shorter duration of efficacy.

Conclusion: In accordance with the results, it could be concluded that 10% Metronidazole and Calcium hydroxide plus 2% Chlorhexidine proved to be beneficial for reducing post-operative pain followed by Septilin; Septilin and 2% Chitosan showed shorter duration of efficacy as compared to other medicaments.