Effect of Calcium Hydroxide as an Intracanal Medicament with Aqueous- and Viscous-Based Vehicles in Patients with Pulpal Necrosis and Symptomatic Apical Periodontitis on Post-operative Pain and Periapical Healing Outcome.

Authors

Lubhansha Kumar, Alpa Gupta, Priya Khandelwal, Vivek Aggarwal, Shreya Asija, Dax Abraham

Published in

European endodontic journal. Sep 07, 2026. Epub Sep 07, 2026.

Abstract

This study aimed to measure the effect of calcium hydroxide with propylene glycol and calcium hydroxide with normal saline as intracanal medicament in patients with pulpal necrosis and symptomatic apical periodontitis on postoperative pain and periapical healing outcome.
For this investigation, 50 patients with symptomatic apical periodontitis and pulpal necrosis in permanent mandibular molar teeth were chosen. Depending on the kind of intracanal medication utilised during the procedure, the participants were divided into 2 groups of 25 patients each at random. Group 1: calcium hydroxide and propylene glycol and group 2: calcium hydroxide and normal saline. All patients with pre-operative pain scores between 60 and 144 mm were asked to record the pain on the Heft-Parker visual analogue scale (HP-VAS) from 6, 24, 48, 72, 96 hours and days 5,6,7.td. The healing of periapical lesions was determined at 0 months, 3 months, 6 months, 9 months and 12 months using the periapical index (PAI) score.
No statistically significant difference in postoperative pain scores was observed between the groups at baseline and during the 1st-4th days (P > .05). The propylene glycol group demonstrated significantly lower pain scores on the 5th, 6th and 7th days compared to the normal saline group (P < .05). No significant difference in periapical healing was observed at the 3-month and 6-month follow-ups (P > .05); however, statistically significant improvements were observed in the propylene glycol group at 9 months and 12 months (P < .05).
Calcium hydroxide used with a viscous vehicle (propylene glycol) demonstrated a greater reduction in postoperative pain after day 4 and improved periapical healing at 9 and 12 months compared to an aqueous vehicle (saline). Although statistically significant differences were observed at specific time points, the clinical relevance of these findings should be interpreted with caution, and further studies are required to confirm these results.

PMID:
42732590
Bibliographic data and abstract were imported from PubMed on 14 Sep 2026.

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