Effect of Bromelain Versus Calcium Hydroxide as an Intracanal Medication on the Intensity of Postoperative Pain and Bacterial Load Reduction in Necrotic Single Rooted Lower Premolars

the aim of the study is to compare the effect of bromelain vs calcium hydroxide as intracanal medication on intensity of pain and bacterial load in necrotic single lower premolars

Inclusion Criteria:Patients who are free from any physical or mental handicapping condition with no underlying systemic disease (ASA I or II) .Age between 25-50 years old.Males & Females.Patients who can understand pain scale and can sign the informed consent.Mandibular Single rooted premolars, having single root canal:Diagnosed clinically with pulp necrosis.Absence of spontaneous pulpal pain.Positive pain on percussion denoting apical periodontitis.Slight widening in the periodontal membrane space with or without periapical radiolucency radiographically.Normal occlusal contact with opposing teethExclusion Criteria:Medically compromised patients: Pain levels and healing following treatment would be compromised as these patients have shown higher incidence of pain and lower healing rate.Pregnant women: Avoid radiation exposure, anesthesia, and medication.If antibiotics have been administrated by the patient during the past 12 hours preoperatively might alter their pain perception.Patients reporting bruxism or clenching: Avoid further pressure on an already inflamed tooth inducing subsequent irritation and inflammation.Teeth that shows association with acute periapical abscess and swelling: Need special treatment steps which could involve additional visits with incision and drainage. Also, it could influence initiation and progression of postoperative pain.Greater than grade I mobility or pocket depth greater than 5mm. Need special surgical and/or periodontal therapy.No restorability: Hopeless tooth.Immature teeth.Radiographic evidence of external or internal root resorption.