Evaluation of Postoperative Pain and Antimicrobial Efficacy of Selenium Versus Calcium Hydroxide As Intracanal Medication in Mandibular First Molars with Necrotic Pulp and Symptomatic Apical Periodontitis

The main rational behind intracanal medicament is to kill the bacteria inside the rootcanal and to avert reinfection. In absence of nutrients, the bacteria remains afterobturation in root canal may not survive. Otherwise they may flourish & If the root canalis not dressed properly with antiseptic medicaments between the visits, the residualbacteria may increase . Thus the use of effective intracanal medication for disinfectionof root canal is necessitated . Medicament with long effect and least irritated toperiradicular tissue has to be introduced to infiltrate the dentinal tubule eliminatingbacteria . As the effect of intracanal medicaments is longer than irrigants, it isgenerally recommended to fill the root canal between appointments with intracanalmedicaments. Calcium hydroxide is the most commonly recommended antimicrobial agent forinterappointment medications. It serves as an effective intracanal medicament due to itsalkaline pH, which inhibits bacterial growth. However, calcium hydroxide has limitations..Recently selenium(Se) was introduced as intracanal medication .Se is a mineral essentialfor the formation of the amino acid selenocysteine, which is directly involved in themaintenance of the immune response. Selenium has been widely used in the medical field inthe treatment of cancer, as an activator of bone metabolism, and as a stimulator of theimmune system. In this study, it will show that the incorporation of Se, whether asintracanal medication alone or in conjunction with other medications, may potentiateperiapical tissue repair after RCS cleaning and shaping procedures.This study consists of 60 patients divided into 3 group each group having 20 patient.Intervention 1: intracanal medication using selenium alone .Intervention 2: intracanal medication using selenium with calcium hydroxide