Comparative evaluation of calcium hydroxide and other intracanal medicaments on postoperative pain in patients undergoing endodontic treatment: A systematic review and meta-analysis.

Abstract

Aim: The aim of this study was to evaluate the effect upon postoperative pain in teeth of patients suffering from apical periodontitis or necrotic pulp when treated with calcium hydroxide and compare it with other intracanal medicaments.

Materials and methods: MEDLINE database, PubMed and Google Scholar databases were searched based on the filters and inclusion and exclusion criteria. The screening was done to finally acquire 9 articles from the mass of searched articles. The data extraction followed the screening process, and qualitative and quantitative data were recorded. The risk of bias was conducted with the Cochrane Collaboration tool, and meta-analysis was done using Review Manager version 5.3.

Results: A total of 9 studies over the past five decades met the inclusion criteria for full-text reading, and all 9 of them were included for further analysis. When we assessed for pain outcome, in comparison with CHX and Ca(OH), the cumulative mean difference was -4.57 (confidence interval: -16.25, 7.11). The heterogeneity was significant I² = 95%, hence we applied the random effects model. The mean difference showed that the mean pain outcome was more in the control (Ca(OH)) group, as compared to the intervention group.

Conclusion: Calcium hydroxide is effective in reducing posttreatment pain when it is used alone, but its effectiveness can be increased when used in combination with other medicaments such as chlorhexidine.