Evaluation of the efficacy of irrigation with pomegranate peel extract and apple cider vinegar in disinfecting the necrotic root canals of primary teeth

INTERVENTION: A randomized double‐blinded, controlled, comparative clinical study comparing the efficacy of pomegranate peel extract soaked in apple cider vinegar with sodium hypochlorite liquid and with apple cider vinegar in reducing bacterial counts in the canals of anterior primary teeth. Sample description The sample size was calculated using the G‐Power program (3.1.9.4) at a confidence level of 95% and a level of significance of 0.05, and based on similar previous studies, the sample will consist of 45 necrotic anterior primary teeth (incisors, laterals and canines), and the sample will be randomly distributed into three groups (n=15) using https://www.randomizer.org/ The study will be conducted on children aged from 3‐9 years, and each group consisting of 15 ages will be divided as follows: 1. The first group (n = 15): irrigation of the canals with pomegranate peel extract soaked with apple cider vinegar. 2. The second group (n = 15): irrigation of the canals with apple cider vinegar. 3. The third group (control) (n = 15): irrigated the canals with 3% sodium hypochlorite. Randomization is carried out using https://www.randomizer.org. Participants are followed up at 1 week. CONDITION: Disinfecting the necrotic root canals of primary teeth ; Oral Health PRIMARY OUTCOME: Disinfection of the root canals is measured by counting colony‐forming units (CFUs) from the cultivated samples taken from the canals before and after irrigation with each solution SECONDARY OUTCOME: Pain on biting measured using clinical examination at 1 week postoperatively INCLUSION CRITERIA: 1. Children 3‐9 years old. 2. Children who have not taken antibiotics during the past two months. 3. The teeth (primary incisors and canines show no signs of internal radical resorption. 4. Signs of a clinically necrotic tooth with secretion of pus or fistula. 5. Radiographical transparency around the root with resorption less than one‐third of the root.