Evaluation of the Aloe Vera Anti-inflammatory Effect on Apical Periodontitis.

The goal of this clinical trial is to evaluation aloe vera as intracanal medication anti-inflammatory also inter-appointment pain incidence compared with calcium hydroxide. The main questions it aims to answer are: Does aloe vera reduced pro-inflammatory cytokine (IL-1b)? Researchers will compare aloe vera to calcium hydroxide intra-canal medication to see if it works to modulate the inflammatory response in necrotic teeth with apical periodontitis. Participants will: Receive the intra-canal medications following root canal preparation for 14 days, periapical tissue fluid samples will be collected after access cavity preparation and 14days post medication placement. Pre-operative pain level and 24h, 48h post medication placement will be recorded.

Inclusion Criteria: 1. Both genders. 2. Older than the age of 18 years. 3. Medically free patients. 4. Participants should be willing to commit for the entire period of the trial and agreed to sign the written informed consent after complete explanation of the study protocol. 5. Participants with single rooted necrotic teeth with apical periodontitis, symptomatic (Visual analogue scale "VAS" and pain on percussion) or Asymptomatic (Radiographic evidence of apical periodontitis). Exclusion Criteria: 1. Presence of Allergic reaction. 2. Participants taking antibiotics or NSAIDs. 3. Severely curved root. 4. Endodontically treated teeth. 5. Teeth with open apices.