POST-OBTURATION PAIN EVALUATION AFTER NON-SURGICAL DEBULKING OF PERIAPICAL PATHOSIS AND INTRACANAL INJECTION OF GROWTH HORMONE (AN IN VIVO STUDY)

Background: This study aimed to evaluate and compare post-obturation pain following non-surgical debulking of periapical pathosis using XP-Endo Finisher and the intracanal injection of Growth Hormone in single-rooted necrotic teeth that were obturated using EndoSeal MTA sealer. Methods: This single-blind randomized controlled clinical trial registered fifty-four patients presenting with necrotic, mature, permanent, single-rooted teeth associated with periapical lesions measuring 2–4 mm in diameter and classified as score 3 on the Cone Beam Computed Tomography Periapical Index (CBCTPAI). Following comprehensive clinical and radiographic assessment, participants were randomly assigned into three equal groups (n = 18). In Group I (GHES), growth hormone (SEDICO, 6 October, Egypt) (GH) was applied periapically prior to root canal obturation with EndoSeal MTA (Maruchi, Wonju, South Korea) (ES) sealer, Group II, (XP-ES) non-surgical debulking of periapical pathosis using XP-Endo Finisher (FKG,Dentrie Switzerland) file was done prior to root canal obturation with EndoSeal MTA (ES), whereas in Group III (ES), obturation was performed using ES sealer alone. Preoperative pain levels were assessed using the Arabic-translated version of the Verbal Descriptor Scale (VDS). Postoperative pain grades were noted at baseline (preoperatively), and at 6, 24, 48, and 72 hours, as well as 1 week after treatment. Results: A statistically significant difference was observed between the three groups at 6, 24, and 48 hours postoperatively (p =0.001, 0.001, 0.005 respectively), with the GH-ES group showing lower pain scores and XP-ES group showing the highest pain scores. However, no significant differences were noted at 72 hours or at one week. All groups exhibited a progressive and significant decrease in pain scores over time (p =0.001).