الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Endodontic postoperative pain is a common unexpected complication. The hypothetical mechanisms for this complication include chemical, mechanical or microbial injury to the periradicular tissue. Intra-canal medicaments are widely used to kill any bacteria surviving after instrumentation and irrigation. The aim of this study was to assess the ability of oleaonlic acid versus ledermix, corticosteroid/antibiotic combination and calcium hydroxide used as intracanal medication in reducing postoperative pain. Method: 50 Patients with necrotic pulp apical periodontitis were randomly assigned into five groups according to the intra-canal medication used: ledermix, corticosteroid/antibiotic combination, calcium hydroxide, oleaonlic acid and no dressing. Pre-operative pain was recorded using numerical rating scale (NRS), visual analog scale (VAS) and verbal rating scale (VRS). After isolation, access cavity was performed followed by chemico-mechanical preparation using protaper.Next files with 2.5% sodium hypochlorite irrigation. Subsequently, intra-canal medication was placed and postoperative pain was recorded after 4 hours then daily for 4 days postoperatively using the three scales. Results: Pre-operatively; there was no statistically significant difference between mean pain scores in the five groups. After 4 hours and daily for 4 days, oleanolic acid and ledermix paste showed highly significant results in reducing the inter-appointment pain followed by corticosteroid/antibiotic combination, calcium hydroxide while no dressing exhibit less pain reduction. Conclusion: Oleanolic acid is an efficient intracanal medicament for control postoperative pain comparable to ledermix which is a gold standard pain controlling medication. Antibiotic /corticosteroid prepared past and calcium hydroxide may consider an acceptable medication for reduction of postoperative pain. Keywords: apical periodontitis, calcium hydroxide, antibiotic paste, intra-canal medication, postoperative pain, ledermix, oleaonlic acid.