Effect of Intracanal Medicament Type on Postoperative Pain - A Prospective Study

The aim was to comparatively evaluate the ability of Ledemix and non-setting calcium hydroxide intracanal medicaments to reduce postoperative pain in teeth undergoing root canal treatment (RCT).

A single-blinded, randomised controlled clinical trial was conducted at Ajman University College of Dentistry, involving 59 patients requiring RCT on maxillary and mandibular first molars. Patients were randomly allocated into two groups: Group 1 received Ledermix paste, while Group 2 received non-setting calcium hydroxide paste. Treatments were performed by supervised fifth-year dental students using standardised aseptic techniques. Local anesthesia was administered, and rubber dam isolation was ensured. After access cavity preparation, root canals were instrumented using WaveOne Gold Files with sodium hypochlorite irrigation. The assigned intracanal medicament was placed, and the cavity was sealed with a temporary restoration. Pain levels were assessed preoperatively and at 4 h and 4 days postoperatively using a visual analogue scale by a blinded investigator. Clinical and demographic data, including age, gender, smoking status, medical history, and pulpal/periapical diagnoses, were recorded.

Data were analysed using SPSS 28.0. T-tests were used to compare pain levels between groups, with significance set at P < 0.05. The average pain score decreased significantly from 3.95 ± 0.52 preoperatively to 1.47 ± 0.30 at 4 h and 0.42 ± 0.18 at 4 days postoperatively ( P = 0.001). Ledermix was associated with greater pain reduction at 4 h ( P = 0.004), no significant differences between groups were observed at 4 days ( P = 0.665).

Both medicaments effectively reduced pain, with Ledermix offering superior early relief.