Comparative evaluation of chitosan nanoparticles and ethylenediaminetetraacetic acid as intracanal irrigants and their effect on postoperative pain reduction in single-sitting root canal treatment - A randomized controlled trial.

Ethylenediaminetetraacetic acid (EDTA) is the conventional irrigating agent used in endodontics for the removal of the smear layer. However, its propensity for periapical irritation may frequently exacerbate postoperative pain in single-visit endodontics. In contrast, chitosan nanoparticles (CNPs) serve as a superior, biocompatible alternative that facilitates effective removal of the smear layer. Consequently, this study evaluates the effect of CNPs and EDTA on postoperative pain following single-visit root canal therapy. This study compares the effect of 0.2% nanochitosan and 17% EDTA in postoperative pain reduction when used as the final irrigant in symptomatic irreversible pulpitis. Forty patients with symptomatic irreversible pulpitis were randomly assigned to two groups (n = 20). Following chemomechanical preparation, final irrigation utilized 5 mL of 17% EDTA in one group and 5 mL of 0.2% CNPs in the other, both ultrasonically activated. Pain levels were self-recorded using a Numeric Rating Scale at 6, 12, 24, 48, and 72 h posttreatment. Data were analyzed using SPSS 26.0 (P < 0.05). After confirming normality using the Shapiro-Wilk test, data (mean ± SD) were compared using independent t-tests (intergroup) and repeated-measures analysis of variance with Bonferroni post hoc tests (intragroup). Both groups demonstrated a highly significant, progressive pain reduction from baseline to 72 h. The CNP group consistently recorded lower mean pain scores overall, with a statistically significant difference observed at the 12-h evaluation (P = 0.03). While both agents effectively reduced postoperative pain, 0.2% CNPs proved to be a clinically superior alternative to EDTA, offering better pain mitigation and structural dentin preservation.