Evaluation of the effect of different irrigation solutions used in regenerative endodontic treatment of necrotic molar teeth with open apex on postoperative pain- randomized clinical trial

Objectives This study evaluates the effect of different irrigation solutions for postoperative pain in the regenerative endodontic treatments (RET) of necrotic teeth with open apex. Materials and methods This study included necrotic, deeply carious lower molars of 42 patients. Access cavities of the teeth were opened and working lengths were measured at the first visit. In Group 1, the root canals were irrigated with 1.5% sodium hypochlorite (NaOCl) and 17% Ethylenediaminetetraacetic-acid (EDTA), in Group 2, with 1.5% NaOCl and 10% citric acid, and in the Group 3, with 1.5% NaOCl and 9% Etidronic acid (HEDP) mixture solution. Final irrigation was performed with distilled water. The canals were dried, filled with calcium hydroxide paste, and sealed with Cavit. Postoperative pain was assessed using a numerical rating scale, and Paracetamol was prescribed. At the second visit, calcium hydroxide was removed with 1.5% NaOCl, irrigated with chelators, and sealed with Sure-Seal PT 3 mm below the cementoenamel junction before composite resin filling. Results Postoperative pain was higher in Group 3 (p < 0.05), but analgesic consumption did not show a significant difference (p > 0.05). Conclusions HEDP caused significantly more postoperative pain than EDTA and citric acid (p < 0.05). While the study provided information regarding the effects of irrigation solutions on postoperative pain, further research is needed as it did not include detailed assessments of long-term periapical healing and apex closure. Clinical relevance When HEDP is used as a chelation agent in RETs, it shows a higher degree of postoperative pain than EDTA and citric acid solutions. Clinical trial registration The study protocol was registered at www.clinicaltrials.gov (ID: NCT 06386991).