111 Different pharmacological solutions in intracanal irrigation KR Paudel, 1 A Jaiswal, 2 U Parajuli 3 and M Bajracharya 3 1 Department of Clinical Pharmacology, Kathmandu Medical College and Teaching Hospital (KMCTH), Kathmandu, Nepal, 2 Department of Dentistry, Universal College of Medical Sciences (UCMS), Bhairahawa, 3 Department of Dentistry, National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu, Nepal Corresponding author: Dr Keshab Raj Paudel, Lecturer, Department of Clinical Pharmacology, Kathmandu Medical College and Teaching Hospital (KMCTH), Kathmandu, Nepal; e-mail: keshabpaudel@gmail.com; phone: 977-9849024853 ABSTRACT Irrigation of root canals during endodontic therapy is an important step. Sodium hypochlorite (NaOCl), hydrogen peroxide (H 2 O 2 ), chlorhexidine (CHX) and normal saline are commonly used intracanal irrigants to disinfect and clean the root canals. This prospective study was set to observe the efficacy of normal saline (0.9% NaCl) irrigation with sequential irrigation of 3% H 2 O 2 , 5.2% NaOCl and 0.9% NaCl. A total number of 228 dental patients were screened and 104 patients fulfilling the inclusion criteria were enrolled for the endodontic therapy of mature permanent teeth for the period of one year. Two treatment groups were constituted in which patients were randomly allocated equally in each treatment group. Post-obturation pain, swelling, analgesic use and eight weeks post-obturation radiological evaluation of the patients were carried out as the measurement of clinical and radiological success of the endodontic treatment. No statistically significant differences were observed in the measured treatment outcomes between two groups. However, studies involving larger sample size and longer post-obturation follow up are recommended for the further either confirmation or rejection of present findings. Keywords: Endodontics, irrigation, obturation, normal saline, root canal treatment INTRODUCTION Dental caries is the global dental public health problem in all age groups and its prevalence ranges from 13% to 96%. 1-4 Inappropriate brushing techniques, sticky food habits, low socioeconomic status and lack of public awareness towards oral health are the major factors that lead to the bad corollary of the dental caries. Dental caries may progress to reversible pulpitis that results in irreversible pulpitis which entails endodontic therapy. 5,6 Endodontic therapy itself is quite expensive, requires more chair side time and, in most of the cases, multiple visits to the dental clinic or hospital. Concurrent use of antibiotics, analgesics, intra-operative root canal irrigants and medicaments are partly accountable for the high cost of endodontic treatment. Among many intracanal irrigation solutions, 7 3% hydrogen peroxide (H 2 O 2 ), 5.2% sodium hypochlorite (NaOCl) 8-10 and 0.9% normal saline NaCl and chlorohexidine (CHX) 7 are very popular and commonly used conventional intracanal irrigants. 5.2% NaOCl has the solvent action on the organic debris of pulp tissue. Similarly, the effervescent reaction of 3% H 2 O 2 pushes debris out of the root canals through the least resistant orifice into the pulp chamber. Besides the above actions of these two irrigants, the disinfecting, bleaching and antimicrobial action by both solutions helps disinfect the root canals. 7 However, 0.9% NaCl has no antibacterial action, 11 but has only the cleaning effect during intracanal irrigation. In this study, efficacy of 0.9% NaCl irrigation alone was compared with the sequential irrigation of 3% H 2 O 2 , 5.2% NaOCl and 0.9% NaCl during root canal treatment. METHODS As certain conditions or factors in the patients may influence the treatment outcomes especially analgesic use and healing capacity, and the patients’ co-operation, following exclusion criteria and inclusion criteria were set up during the selection of the samples. Exclusion criteria: Patients with odontogenic abscesses or cellulitis, phychiatric diseases, neuropathic pain, uncontrolled diabetes mellitus, immune deficiency and concurrent systemic diseases which warrant the use of analgesic agents such as arthritis, myalgia, cancer, burn, etc were excluded from the study. Moreover, patients, who required endodontic treatment with concurrent fractures in the oral or other regions, were under systemic corticosteroids or other immunosuppressant and analgesic therapy, needed more than one endodontic treatment and were not willing for the treatment, were not enrolled. Inclusion criteria; Patients with acute or chronic irreversible pulpitis of mature permanent teeth with or without acute apical periodontitis and without exclusion criteria were Original Article Nepal Med Coll J 2011; 13(2): 111-114