Abstract:

Objectives: Evaluation of the effect of calcium hydroxide combined with silver nanoparticles solution with calcium hydroxide as intracanal dressing following non-surgical root canal retreatment on postoperative pain and compare it with conventional calcium hydroxide. Materials and methods: randomized, prospective, parallel, triple-blind clinical trial includes one hundred and twenty eligible patients, who were medically free with symptomatic apical periodontitis and had previously endodontically treated anterior or premolar teeth, their age were ranged between 25-50 years. They were randomly and equally divided into two groups according to the added solution either nanosilver solution or distilled water. Opaque bottles of nanosilver solution or distilled water were covered and coded either A or B by dental assistant who prepared the intracanal medicament paste by mixing one of solutions with Ca(OH)₂ powder then gave the paste to the operators. Operators and patients were blinded into which group patient will be enrolled. Patients were assessed pain pre-operatively and after 6, 12, 24 and 48 hours postoperatively by Numerical Rating Scale (NRS). Mann–Whitney U, Wilcoxon’s rank, Friedman’s and chi-square (χ²) test used for analyzing outcome data. Calculation of Relative Risk (RR), Relative Risk Reduction (RRR) and 95% confidence interval (CI) were done. Results: revealed that there was no statistically significant difference in postoperative pain incidence and intensity at different time intervals between two groups. But there was statistically significant difference in pain intensity within same group (P<0.05). At 6, 12, 24, 48 h the RR of pain incidence and its 95% CI were 0.861 (95% CI: 0.625, 1.186), 0.870 (95% CI: 0.538, 1.406), 0.535 (95% CI: 0.231, 1.255), 0.33 (95% CI: 0.070, 1.586) respectively. No adverse or side effects for any materials used were reported. Conclusions: Although the relative risk of pain incidence was lower in the treatment group compared to the control group, the confidence intervals crossed 1, indicating no statistically significant difference. Further studies with larger samples are required.