Comparative Evaluation Of Different Irrigants On Substance P Expression For Single Visit Root Canal Treatment Of Teeth With Irreversible Pulpitis - A Double Blinded Study

Endodontic treatment plays a vital role in managing pulpal and peri-radicular infections caused by a diverse array  of microorganisms present in the root canal. The success of endodontic treatment is contingent upon the proper execution of key procedures, including biomechanical preparation, irrigation, and root canal obturation.The adoption of single-visit root canal treatment is gaining popularity in certain endodontic practices. Nonetheless, a significant apprehension associated with this approach is the concern for post-operative pain. Neuropeptides are bioactive peptides predominantly produced in neurons. Substance P, identified as the first neuropeptide in dental tissues, plays a crucial role in influencing blood flow, inflammatory processes, and immune responses. Ketorolac tromethamine, a potent nonsteroidal anti-inflammatory drug (NSAID), is available in both oral and injectable forms. Sodium hypochlorite (NaOCl) stands as the gold standard and the most frequently utilized root canal irrigant, primarily owing to its notable antimicrobial activity, effectiveness against biofilms, and capacity to dissolve soft tissues. However, it exhibits certain undesirable characteristics, including its potential to irritate periapical tissues even at low concentrations, particularly when extruded beyond the apex in teeth with an open apex and nonvital pulps. However, herbal and natural products have become a focal point of research globally in recent years due to their medicinal properties.Neem (Azadirachta indica), also known as the margosa tree, is a natural product gaining attention in endodontic research. Moringa oleifera, a tree indigenous to India and a member of the Moringaceae family, is colloquially known as the "drumstick" or "horseradish" tree. The leaves of M. oleifera are abundant in flavonoids and phenolic compounds, showcasing significant antioxidant and anti-inflammatory properties.