Jasminum-based Nano-reinforced Calcium Hydroxide Reduces Postoperative Pain in Symptomatic Apical Periodontitis: A Randomized Controlled Trial.

INTRODUCTION

This study evaluated the efficacy of a novel Jasminum-based titanium dioxide nano-reinforced calcium hydroxide (Ca(OH)2) intracanal medicament in reducing postoperative pain (PP) compared to conventional Ca(OH)2 in patients with symptomatic apical periodontitis.

METHODS

A triple-blind randomized clinical trial, registered at ClinicalTrials.gov (NCT06653608, 10/19/2024) included patients with single-rooted teeth diagnosed with pulp necrosis and symptomatic AP. Patients referred for endodontic treatment fulfilling the inclusion criteria were included. The patients were grouped into nano-reinforced Ca(OH)2 group (n = 30) and conventional-Ca(OH)2 (n = 30). Preoperative pain and PP at 4, 24, 48, 72, and 96 hours were recorded using a visual analog scale. Data were analyzed using linear mixed-effects models (R software, version 4.3.2., R Core Team, Vienna, Austria), with significance set at P < .05.

RESULTS

Sixty patients with comparable demographic and clinical characteristics, including preoperative pain scores, were recruited. Both groups exhibited significant pain reduction over 96 hours (P < .001). However, a significant group-time interaction was observed (P < .001), with the nano-reinforced Ca(OH)2 group reporting consistently lower PP scores and greater reductions in PP compared to the conventional Ca(OH)2 group at all-time points.

CONCLUSION

The incorporation of Jasminum-based TiO2 nanoparticles to Ca(OH)2 significantly improved the reduction in PP intensity and duration compared to conventional Ca(OH)2, making it a superior option for PP management.