الفهرس 
ffect of neem (Azadirachta Indica) versus 2.5% sodium hypochlorite as root canal iIrrigants on the intensity of post- operative pain and amount of endotoxins in necrotic teeth : A randomized clinical trial
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Abstract
Aim: To assess the effect of neem (Azadirachta indica) versus 2.5% sodium hypochlorite (NaOCl) as root canal irrigants on the intensity of postoperative pain and the amount of endotoxins in patients with necrotic mandibular molar teeth in a randomized clinical trial. Methods: Fifty patients were included. After confirming diagnosis clinically and radiographically, patients were randomly assigned into two equal groups. In the intervention group, canals were irrigated using neem irrigant; while NaOCl 2.5% was used in the control group. Standard endodontic treatment was performed in two-visits using ProTaper Next rotary system and a cold lateral condensation technique with AdSeal resin-based root canal sealer was used for obturation. Pain was assessed using a numerical rating scale (NRS) and recorded at 6, 12, 24, and 48 hours after both instrumentation and obturation visits. Endotoxin samples were collected by three paper points immediately after access cavity preparation (S1) and after chemo-mechanical preparation (S2). A sandwich ELISA method was used for the quantification of endotoxins. All demographic, baseline, and outcome data were collected and statistically analyzed Results: Regarding post-instrumentation pain, both groups showed the highest mean pain score at 6 hours postoperatively which decreased gradually to reach the least value at 48 hours with a statistically significant difference between them at 24 hours in which neem recorded the lowest mean pain score. After obturation, both groups showed the highest mean pain score at 6 hours postoperatively which decreased gradually to reach the lowest value at 48 hours postoperatively with no statistically significant difference between them at all time-points