Thesis (M.Sc.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Endodontics

This study assessed the effect of combination of calcium hydroxide and chlorhexidine gel 2% as intracanal medication in comparison to calcium hydroxide paste as intracanal medication on postoperative pain and bacterial endotoxins in necrotic teeth. Forty five patients with single rooted tooth with necrotic pulp were assigned into groups A, B, and C. In group A: calcium hydroxide combined with 2% chlorhexidine gel was placed, in group B: Calcium hydroxide paste was placed, while in group C: no intracanal medication was placed after chemo-mechanical preparation for 14 days. Postoperative pain was assessed by numerical pain rating scale (NRS) after 4, 24, 48 hours after the first visit and after 14 days at the day of obturation, while endotoxin assessment was performed by limulus amebocyte lysate test by taking samples from the root canal after access cavity preparation, after chemo-mechanical preparation before the application of the intracanal medications and after 14 days before the obturation. The results revealed that there is no statistically significant difference in postoperative pain reduction between the three groups. However, there is statistically significant difference in endotoxin reduction between group A: Calcium hydroxide combined with 2% chlorhexidine gel and group B: Calcium hydroxide paste and group C: no intracanal medication. The greatest reduction was occurred with group A followed by group B then group C

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