Effect of Apical Enlargement to Different Preparation Sizes and Tapers on Pain and Bacterial Reduction in Necrotic Pulp

The aim of this prospective randomized clinical trial is to evaluate the effect of different apical size and taper preparation (35. 04; 35. 06; 45. 04 and 45. 06) on postoperative pain at 6, 12, 24, 48 and 72 hours, and intra-canal bacterial count in patients having mandibular premolars with necrotic pulps.

Inclusion Criteria:Systemically healthy patients, American Society of Anesthesiologists (ASA) I and II.Patient's age ranges between 18 to 35 years with no sex predilection.Patients with single-rooted mandibular premolars with asymptomatic necrotic pulp.Patients who can understand the Numerical Rating Scale (NRS).Patients able to sign informed consent.Exclusion Criteria:Pregnant females.Mandibular premolars with periodontal pockets greater than 5 mm or greater than grade I mobility.Patients have a positive history of antibiotic use or analgesic use within the past week or required antibiotic premedication for dental treatment (such as prosthetic joint prophylaxis).Patients have teeth that have been previously accessed.Teeth with extensive crown destruction by caries that will not permit rubber dam placement.Teeth associated with acute periapical abscess, swelling or a fistulous tract.Radiographic evidence of external or internal root resorption vertical root fracture, perforation, calcification.