Background: Flare-ups may occur after root canal treatment which consist of acute exacerbation of asymptomatic pulpal and/or periradicular pathologic condition. The causative factors of interappointment pain include mechanical, chemical or microbial irritation to the pulp or periradicular tissues. The potential role of microorganisms in interappointment pain is why the success of endodontic treatment depends on complete eradication of microorganisms capable of causing an intraradicular or extraradicular infection. This can be achieved by mechanical cleaning and shaping, in conjunction with irrigation and antibacterial agents. The aim of this study was to assess the ability of triple antibiotic paste with the anti-inflammatory drug diclofenac potassium versus calcium hydroxide used as an intra-canal medication in reducing post-operative pain. Methods: 84 patients with asymptomatic uniradicular necrotic teeth were randomly assigned into two groups according to the intra-canal medication used: calcium hydroxide group (CH) and triple antibiotic paste with diclofenac potassium group (TAPC). In the first treatment session, intracoronal cavity preparation was performed after rubber dam isolation followed by chemo-mechanical preparation using rotary Protaper Universal files with saline irrigation followed by intra-canal medication placement then postoperative pain was assessed at 24, 48 and 72 hours postoperatively using Visual Analogue Scale (VAS). In the second treatment session, intracanal medications were removed by irrigation using saline followed by obturation. Results: Both intracanal medicaments resulted in a statistically significant decrease in mean pain value from 24 to 48 and 72 hours postoperatively. While when comparing both groups, TAPC intracanal medication showed less post-operative pain compared to that of the CH group at 24, 48 and 72 hours with a statistically significant difference at 48 hours only. Conclusion: Both intracanal medicaments were efficient in reducing post-operative pain in asymptomatic uniradicular necrotic teeth. Trial registration: Clinicaltrial.gov NCT02907489, 20/09/2016.

Aim: The present study evaluated the effect of different final irrigation protocols on the apical sealing ability of bioceramic and epoxy resin-based sealers. Materials and methods: Thirty single-rooted mandibular premolars were instrumented using ProTaper Next rotary files. Teeth were randomly divided into three groups according to the final irrigation regimen; Group I: 5 ml 0.2% CNPs/3 min, Group II: 2.5 ml 0.2% CNPs/1.5 min followed by 2.5 ml 17% EDTA/1.5 min, and Group III: 5 ml 17% EDTA/3min. All groups were subdivided into two subgroups based on the obturation material; Subgroup A: gutta-percha/Sure-Seal Root BC Sealer and Subgroup B: gutta-percha/AH Plus. The apical sealing ability was assessed using modified silver staining technique. Samples were sectioned longitudinally and examined using SEM. Results: Sure-Seal Root BC sealer showed significantly lower nanoleakage compared to AH Plus. No significant difference was recorded in the nanoleakage of Sure-Seal Root BC sealer among the three groups, while AH Plus showed a significantly higher nanoleakage in the EDTA group. Conclusions: The apical sealing ability of bioceramic sealers is better than that of epoxy resin-based sealers. The type of the final irrigating solution seems to affect the post-obturation seal of both AH Plus and Sure-Seal Root BC sealer.

Background: Flare-ups may occur after root canal treatment which consist of acute exacerbation of asymptomatic pulpal and/or periradicular pathologic condition. The causative factors of interappointment pain include mechanical, chemical or microbial irritation to the pulp or periradicular tissues. The potential role of microorganisms in interappointment pain is why the success of endodontic treatment depends on complete eradication of microorganisms capable of causing an intraradicular or extraradicular infection. This can be achieved by mechanical cleaning and shaping, in conjunction with irrigation and antibacterial agents. The aim of this study was to assess the ability of triple antibiotic paste with the anti-inflammatory drug diclofenac potassium versus calcium hydroxide used as an intra-canal medication in reducing post-operative pain. Methods: 84 patients with asymptomatic uniradicular necrotic teeth were randomly assigned into two groups according to the intra-canal medication used: calcium hydroxide group (CH) and triple antibiotic paste with diclofenac potassium group (TAPC). In the first treatment session, intracoronal cavity preparation was performed after rubber dam isolation followed by chemo-mechanical preparation using rotary Protaper Universal files with saline irrigation followed by intra-canal medication placement then postoperative pain was assessed at 24, 48 and 72 hours postoperatively using Visual Analogue Scale (VAS). In the second treatment session, intracanal medications were removed by irrigation using saline followed by obturation. Results: Both intracanal medicaments resulted in a statistically significant decrease in mean pain value from 24 to 48 and 72 hours postoperatively. While when comparing both groups, TAPC intracanal medication showed less post-operative pain compared to that of the CH group at 24, 48 and 72 hours with a statistically significant difference at 48 hours only. Conclusion: Both intracanal medicaments were efficient in reducing post-operative pain in asymptomatic uniradicular necrotic teeth. Trial registration: Clinicaltrial.gov NCT02907489, 20/09/2016.