الفهرس 
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Abstract
The aim of the present study Was directed to evaluate is the postoperative pain and periapical healing after using two different irrigating systems and two different sealers in lower first molars .
90 patients with lower first molar in acute pulpitis with apical periodontitis underwent two visits of root canal treatment, in the first visit Root canals were mechanically prepared using fanta blue rotary system then randomly divided into three equal groups according to the irrigation technique ,group(A) : vibringe sonic irrigating (n=30) ,system, group (B) : Diode laser activation (n=30) and group (C) side vented navitip needle (n=30) . In the second visit patients in the each group of the 3 groups is subdivided in to two equal groups according to the sealer used for obturation : group AH plus (n=15) and group ceraseal calcium silicate biocermic sealer (n=15). The trial design of this study is a Parallel randomized controlled trial. All demographic data, clinical and radiographic findings and numerical rating scale scores obtained from patients were statistically analyzed. Results showed that there was no statistically significant difference comparing the three groups of irrigation regarding the demographic data, prevalence of pre-operative pain, after 4 hours, 12 hours, 24 hours, 48 hours except at 72 hours and 7 days ,regarding sealer type Comparison between the six groups were statistically not significant at preoperative and after one year while Comparing overtime from preoperative to post after one year were statistically significant ; being reduced in groups 2, 4, 5 and 6 . While in groups 1 and 3 it was reduced too but not statistically significant.
- Within the limitations of this study, it could be concluded that:
there was no statistically significant difference comparing the three groups of irrigation (vibringe , diode laser, side vented needle) except in 72 hours and 7 days., while in three groups there was a statistically significant decrease in pain intensity preoperatively compared with all other time periods.
Regarding sealer type Comparing overtime from preoperative to post after one year were statistically significant ; being reduced in groups 2, 4, 5 and 6 . While in groups 1( vibringe and ah plus) and group 3 (diode laser and ah plus) it was reduced too but not statistically significant.