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Abstract
Forty patients suffering from symptomatic root canal treatment failure in anteriors and premolars teeth were included. After confirming the diagnosis clinically and radiographically, patients were randomly assigned into two equal groups of 20 patients each. The calcium hydroxide combined with silver nano particles assigned to the intervention group; while the conventional calcium hydroxide was assigned to the control group and both were used as intracanal medicament inside the root canal. Standard endodontic treatment was performed in two visits using rotary nickel titanium files for shaping, 2.5% sodium hypochlorite for cleaning and one shape cone gutta-percha with resin sealer for obturation. Pain was assessed post-operatively 6, 12, 24 and 48 hours after root canal obturation. Numerical Rating Scale (NRS) was used as the primary outcome measure. Patients were given an Ibuprofen (400 mg) to be prescribed as an analgesic in case of emergency pain. All demographic data and NRS scores were collected from the patients and statistically analyzed. Results showed that: After 48 hours post-obturation, conventional calcium hydroxide listed the incidence of no pain 15 patients (75%) less than calcium hydroxide combined with silver nano particles group which listed of no pain 18 patients (90%), and at mild pain calcium hydroxide group listed 5 patients (25%) more than in calcium hydroxide combined with silver nano particles group 2 patients (10%). In addition, conventional calcium hydroxide revealed the incidence of moderate to severe pain 0 patient (0%) same to the calcium hydroxide combined with silver nano particles group