scholarly journals Effect of a 980-nm diode laser on post-operative pain after endodontic treatment in teeth with apical periodontitis: a randomized clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tuna Kaplan ◽  
Güzide Pelin Sezgin ◽  
Sema Sönmez Kaplan
Keyword(s):  
Diode Laser ◽  
Root Canal ◽  
Ethylenediaminetetraacetic Acid ◽  
Apical Periodontitis ◽  
Endodontic Treatment ◽  
Control Group ◽  
Pain Level ◽  
Post Operative Pain ◽  
Average Pain ◽  
Laser Group

Abstract Background This study aimed to assess the effect of a 980-nm diode laser following chemomechanical root canal preparation on the severity of post-operative pain (PP) after root canal treatment (RCT). Methods This study included asymptomatic, single-rooted teeth with a periapical index (PAI) score of 3 or 4. All the patients received RCT, including dressing with calcium hydroxide (Ca(OH)2), during two visits. The patients were randomly divided into two groups (n:30): a control group, in which the final irrigation was performed using 5 ml of 2.5% sodium hypochlorite (NaOCI), followed by 5 ml of 17% and ethylenediaminetetraacetic acid (EDTA) and 5 ml of distilled water, and a laser group, in which the root canals were irradiated using a 980-nm diode laser after the final irrigation at both visits. The pain levels after both visits were evaluated using a visual analogue scale (VAS) after 8 h, 24 h, 48 h and 7 d. In addition, the time intervals to medication intake were recorded. The collected data were statistically analysed using the chi-square and Mann–Whitney U test (p < 0.05). Results The average pain level in the control group 24 h after the first visit was significantly higher than that in the laser group (p < 0.05). The average pain level 24 h and 48 h after the second visit was significantly higher in the control group (p < 0.05). The levels of PP 24 h after the first visit were higher than those after the second visit only in the control group (p < 0.05). After the first visit, analgesic use in the control group was significantly higher after 8 h (40%) and 24 h (23%) as compared with that in the laser group (p < 0.05). Conclusions Root canal irradiation with a diode laser may reduce PP after RCT in single-rooted teeth with a PAI score of 3 or 4. Trial registration: Effect of the Diode Laser on Post-operative Pain After Endodontic Treatment in Teeth with Apical Periodontitis: NCT04486196. Registered 24 July 2020—Retrospectively registered, http://clinicaltrials.gov/ct2/show/NCT04486196

scholarly journals Effect of a 980-nm diode laser on post-operative pain after endodontic treatment in teeth with apical periodontitis: A randomized clinical trial

2020 ◽  
Author(s):  
Tuna Kaplan ◽  
Güzide Pelin Sezgin ◽  
Sema Sönmez Kaplan
Keyword(s):  
Diode Laser ◽  
Root Canal ◽  
Ethylenediaminetetraacetic Acid ◽  
Apical Periodontitis ◽  
Endodontic Treatment ◽  
Control Group ◽  
Pain Level ◽  
Post Operative Pain ◽  
Average Pain ◽  
Laser Group

Abstract Background: This study aimed to assess the effect of a 980-nm diode laser following chemomechanical root canal preparation on the severity of post-operative pain (PP) after root canal treatment (RCT).Methods: This study included asymptomatic, single-rooted teeth with a periapical index (PAI) score of 3 or 4. All the patients received RCT, including dressing with calcium hydroxide (Ca(OH)2), during two visits. The patients were randomly divided into two groups (n:30): a control group, in which the final irrigation was performed using 5 ml of 2.5% sodium hypochlorite (NaOCI), followed by 5 ml of 17% and ethylenediaminetetraacetic acid (EDTA) and 5 ml of distilled water, and a laser group, in which the root canals were irradiated using a 980-nm diode laser after the final irrigation at both visits. The pain levels after both visits were evaluated using a visual analogue scale (VAS) after 8 h, 24 h, 48 h and 7 d. In addition, the time intervals to medication intake were recorded. The collected data were statistically analysed using the chi-square and Mann–Whitney U test (p<0.05).Results: The average pain level in the control group 24 h after the first visit was significantly higher than that in the laser group (p<0.05). The average pain level 24 h and 48 h after the second visit was significantly higher in the control group (p<0.05). The levels of PP 24 h after the first visit were higher than those after the second visit only in the control group (p<0.05). After the first visit, analgesic use in the control group was significantly higher after 8 h (40%) and 24 h (23%) as compared with that in the laser group (p<0.05).Conclusions: Root canal irradiation with a diode laser may reduce PP after RCT in single-rooted teeth with a PAI score of 3 or 4.Trial registration: Effect of the Diode Laser on Post-operative Pain After Endodontic Treatment in Teeth with Apical Periodontitis: NCT04486196. Registered 24 July 2020 - Retrospectively registered, http://clinicaltrials.gov/ct2/show/NCT04486196

scholarly journals Effect of Root Canal Disinfection with 980 µm Diode Laser on Post-operative Pain after Endodontic Treatment in Teeth with Apical Periodontitis: A Randomized Clinical Trial

2020 ◽  
Author(s):  
Tuna Kaplan ◽  
Güzide Pelin Sezgin ◽  
Sema Sönmez Kaplan
Keyword(s):  
Diode Laser ◽  
Root Canal ◽  
Apical Periodontitis ◽  
Endodontic Treatment ◽  
Root Canal Treatment ◽  
Control Group ◽  
Pain Level ◽  
Root Canal Disinfection ◽  
Post Operative Pain ◽  
Average Pain

Abstract Background: This study aims to assess the effect of root canal disinfection with a 980 µm diode laser following chemomechanical root canal preparation on the severity of pain after root canal treatment (RCT).Methods: In present study, asymptomatic, single-rooted teeth with periapical index (PAI) score 3 or 4 were included. All patients were treated with two visits of root canal treatment including dressing with calcium hydroxide. Patients were randomly divided into two groups (n: 28). ‘Control (no laser)’: The final irrigation was performed using 5ml 2.5% NaOCI, followed by 5 ml 17% EDTA and 5 ml distilled water. ‘Laser Disinfection (LD)’: Root canals were irradiated with 980 µm diode laser after final irrigation at both visits. The pain levels were evaluated using visual analog scale (VAS) after 8, 24, 48 hours and 7 days. In addition, analgesic intake and time intervals were recorded by patients. The collected data were statistically analyzed with the Chi-square and Mann-Whitney U test (p<0.05).Results: The average pain level in the control group after 24 hours was significantly higher than that in the laser group after the first appointment (p<0.05). The average pain level after the second appointment was statistically higher at 24 h and 48 h in the control group (p<0.05). PP levels at 24-hs after the first appointment were higher than the second appointment only in the control group (p<0.05). After first appointment, analgesic use in the control group at 8 h (40%) and 24 h (23%) were significantly higher than LD group (p<0.05).Conclusions: Root canal disinfection with diode laser may reduce PP in single-rooted teeth with PAI score 3 or 4.Trial registration: Effect of the Diode Laser on Post-operative Pain After Endodontic Treatment in Teeth with Apical Periodontitis: NCT04486196. Registered 24 July 2020 - Retrospectively registered, http://clinicaltrials.gov/ct2/show/NCT04486196Clinical Trials ID: NCT04486196

scholarly journals Effect of a 980-nm diode laser on post-operative pain after endodontic treatment in teeth with apical periodontitis: A randomized clinical trial

2020 ◽  
Author(s):  
Tuna Kaplan ◽  
Güzide Pelin Sezgin ◽  
Sema Sönmez Kaplan
Keyword(s):  
Diode Laser ◽  
Root Canal ◽  
Ethylenediaminetetraacetic Acid ◽  
Control Group ◽  
Pain Level ◽  
Chi Square ◽  
Root Canals ◽  
Post Operative Pain ◽  
Average Pain ◽  
Laser Group

Abstract Background: This study aimed to assess the effect of a 980-nm diode laser following chemomechanical root canal preparation on the severity of post-operative pain (PP) after root canal treatment (RCT). Methods: This study included asymptomatic, single-rooted teeth with a periapical index (PAI) score of 3 or 4. All the patients received RCT, including dressing with calcium hydroxide (Ca(OH) 2 ), during two visits. The patients were randomly divided into two groups ( n : 30): a control group, in which the final irrigation was performed using 5 ml of 2.5% sodium hypochlorite (NaOCI), followed by 5 ml of 17% and ethylenediaminetetraacetic acid (EDTA) and 5 ml of distilled water, and a laser group, in which the root canals were irradiated using a 980-nm diode laser after the final irrigation at both visits. The pain levels after both visits were evaluated using a visual analogue scale (VAS) after 8 h, 24 h, 48 h and 7 d. In addition, the time intervals to medication intake were recorded. The collected data were statistically analysed using the chi-square and Mann–Whitney U test ( p <0.05). Results: The average pain level in the control group 24 h after the first visit was significantly higher than that in the laser group ( p <0.05). The average pain level 24 h and 48 h after the second visit was significantly higher in the control group ( p <0.05). The levels of PP 24 h after the first visit were higher than those after the second visit only in the control group ( p <0.05). After the first visit, analgesic use in the control group was significantly higher after 8 h (40%) and 24 h (23%) as compared with that in the laser group ( p <0.05). Conclusions: Root canal irradiation with a diode laser may reduce PP after RCT in single-rooted teeth with a PAI score of 3 or 4.

scholarly journals Effect of a 980-nm diode laser on post-operative pain after endodontic treatment in teeth with apical periodontitis: A randomized clinical trial

2021 ◽  
Author(s):  
Tuna Kaplan ◽  
Güzide Pelin Sezgin ◽  
Sema Sönmez Kaplan
Keyword(s):  
Visual Analogue Scale ◽  
Diode Laser ◽  
Root Canal ◽  
Analogue Scale ◽  
Apical Periodontitis ◽  
Control Group ◽  
Pain Level ◽  
Post Operative Pain ◽  
Average Pain ◽  
Laser Group

Abstract Background: This study aimed to assess the effect of a 980-nm diode laser following chemomechanical root canal preparation on the severity of post-operative pain (PP) after root canal treatment (RCT). Methods: This study included asymptomatic, single-rooted teeth with a periapical index (PAI) score of 3 or 4. All the patients received RCT, including dressing with calcium hydroxide (Ca(OH) 2 ), during two visits. The patients were randomly divided into two groups ( n: 30): a control group, in which the final irrigation was performed using 5 ml of 2.5% sodium hypochlorite (NaOCI), followed by 5 ml of 17% and ethylenediaminetetraacetic acid (EDTA) and 5 ml of distilled water, and a laser group, in which the root canals were irradiated using a 980-nm diode laser after the final irrigation at both visits. The pain levels after both visits were evaluated using a visual analogue scale (VAS) after 8 h, 24 h, 48 h and 7 d. In addition, the time intervals to medication intake were recorded. The collected data were statistically analysed using the chi-square and Mann–Whitney U test ( p <0.05).Results: The average pain level in the control group 24 h after the first visit was significantly higher than that in the laser group ( p <0.05). The average pain level 24 h and 48 h after the second visit was significantly higher in the control group ( p <0.05). The levels of PP 24 h after the first visit were higher than those after the second visit only in the control group ( p <0.05). After the first visit, analgesic use in the control group was significantly higher after 8 h (40%) and 24 h (23%) as compared with that in the laser group ( p <0.05).Conclusions: Root canal irradiation with a diode laser may reduce PP after RCT in single-rooted teeth with a PAI score of 3 or 4. Keywords: diode laser, irrigation, post-operative pain, root canal treatment, visual analogue scaleTrial registration: Effect of the Diode Laser on Post-operative Pain After Endodontic Treatment in Teeth with Apical Periodontitis: NCT04486196. Registered 24 July 2020 - Retrospectively registered, http://clinicaltrials.gov/ct2/show/NCT04486196

scholarly journals Periapical status and prevalence of apical periodontitis in patients with type 2 Diabetes mellitus

2021 ◽  
Vol 10 (12) ◽  
pp. e142101220135
Author(s):  
Juliana Érnica Bernardo ◽  
Caroline Loureiro ◽  
Ana Paula Fernandes Ribeiro ◽  
Júlia Guerra de Andrade ◽  
Gladiston William Lobo Rodrigues ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Root Canal ◽  
Apical Periodontitis ◽  
Endodontic Treatment ◽  
Diabetic Group ◽  
Control Group ◽  
Diabetic Patients ◽  
Endodontically Treated Teeth ◽  
Root Canal Filling

Diabetes mellitus (DM) is a chronic systemic disease that affects the immunoinflammatory response, leading the patient more susceptible to the development of oral diseases, such as apical periodontitis (AP). Thus, this study aimed to clinically and radiographically analyze the periapical status and prevalence of AP in diabetic patients compared to healthy patients. A total of 100 patients were selected and divided into two groups (n = 50): diabetic group - patients with type 2 DM, and control group - systemically healthy patients. Periapical status was analyzed by the periapical index. The quality of the root canal filling and restoration was also evaluated. Difference between the prevalence of AP among the groups were performed by using the Chi-square test or Fisher's exact test (p < 0.05). The total number of teeth was lower in diabetic group (p = 0.049). Teeth without previous endodontic treatment with AP were higher in diabetic group (p = 0.006). However, the number of endodontically treated teeth with AP was greater in the control group (p = 0.027). AP in teeth with previous endodontic treatment was associated with unsatisfactory root canal filling and restoration quality (p < 0.01). The presence of pain showed significantly higher values in the diabetic group (p = 0.003). In conclusion, this study showed an association between the presence of AP and DM in cases of teeth without endodontic treatment. Besides, the presence of pain was significantly higher in diabetic patients. However, healthy patients showed more cases of AP in endodontically treated teeth.

scholarly journals COMPARATIVE EFFECTIVENESS OF TREATMENT OF CHRONIC APICAL PERIODONTITIS ON THE BASIS OF DENSITOMETRIC AND MICROBIOLOGICAL RESEARCH METHODS

2019 ◽  
Vol 15 (2) ◽  
pp. 17-24 ◽  
Author(s):  
Лариса Герасимова ◽  
Larisa Gerasimova ◽  
Алина Юсупова ◽  
Alina Yusupova ◽  
Ирина Усманова ◽  
...  
Keyword(s):  
Diode Laser ◽  
Root Canal ◽  
Laboratory Data ◽  
Apical Periodontitis ◽  
Endodontic Treatment ◽  
Canal System ◽  
Periodontal Tissues ◽  
Complex Anatomy ◽  
Group I ◽  
Root Canal System

Relevanct of the research topic. One of the possible causes of apical periodontitis is the infectious inflammatory process of the periapical periodontal tissues. The microflora of the root canal system is represented by various microorganisms, among which streptococci, enterococci and staphylococci most often prevail. The complex anatomy of the root canal system ensures the growth and reproduction of microorganisms, and the endodontic treatment does not always contribute to their qualitative and quantitative reduction. Purpose ― study of the effectiveness of endodontic treatment of chronic apical periodontitis in the near and long term. Methods. We observed 110 patients aged 20 to 30 years with apical periodontitis, bone density analysis and microbiological examination of the contents of the root canal. Depending on the obtained clinical and laboratory data, the patients were divided into two clinical groups: in group I endodontic treatment of 55 teeth was carried out according to the scheme developed by us; in group II — 55 teeth using the standard method of treatment. Results. In endodontic treatment of chronic apical periodontitis, treatment of the root canal system with a diode laser promotes better decontamination of the microflora. Coal mining introduction into the root canal system and in the region of the transition folds of the platelet autoplasma leads to an increase of the reparative process in the periapical region (p≤0.05). Summary. The inclusion in the Protocol of endodontic treatment of apical periodontitis of treatment of the root canal system with a diode laser and injection of platelet autoplasm is a more effective method of treatment in comparison with the traditional one.

scholarly journals Assessment of Extrusion and Postoperative Pain of a Bioceramic and Resin-Based Root Canal Sealer

2019 ◽  
Vol 13 (03) ◽  
pp. 343-348 ◽  
Author(s):  
Braúlio Fonseca ◽  
Marcelo Santos Coelho ◽  
Carlos Eduardo da Silveira Bueno ◽  
Carlos Eduardo Fontana ◽  
Alexandre Sigrist De Martin ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Root Canal ◽  
Ethylenediaminetetraacetic Acid ◽  
Pain Level ◽  
Significant Difference ◽  
Average Pain ◽  
The Mean ◽  
Level Of Significance

Abstract Objectives The objective of this study was to compare a bioceramic and a resin-based endodontic sealer with regard to extrusion and postoperative pain. Materials and Methods Sixty-four patients requiring endodontic treatment of single-rooted maxillary teeth with necrotic pulps were included in this study. The root canal treatments were performed in a single visit using a size 40.06 single-file reciprocating system under 2.5% NaOCl irrigation. After irrigation with 17% ethylenediaminetetraacetic acid (EDTA) and 2.5% NaOCl, the canals were dried and randomly divided into two different groups (n = 32) depending on the sealer used: resin-based group (RG) in which the canals were filled with the AH Plus, and the bioceramic group (BG) in which the canals were filled with the Sealer Plus BC. Ibuprofen (600 mg) was prescribed every 6 hours if the volunteers experienced pain. The patients registered their pain sensation in a visual analog scale (VAS) card, ranging from 0 to 10 at 24-hour, 48-hour, 72-hour, and 1-week intervals. Statistical analysis  For statistical analysis, the level of significance was set at p < 0.05. Results Sealer extrusion occurred in nine patients of the RG and in 19 patients of the BG (p < 0.05). The average pain level at 24-hour and 48-hour intervals was, respectively, 1.46 ± 1.96 and 0.44 ± 0.86 for RG, and 1.21 ± 2.09 and 0.09 ± 0.38 for BG. There was no report of pain after 48 hours. The mean number of tablets taken for pain relief was 0.03 ± 0.17 for RG and 0.06 ± 0.24 for BG. No statistically significant difference was found with regard to pain level and intake of pain killer tablets (p > 0.05). Conclusions The BG sealer presented significantly more extrusion than the RG sealer. Sealer extrusion was not associated with pain. The average pain level and the mean number of tablets taken for pain relief were similar in both groups.

scholarly journals MONITORING OF THE MICROCIRCULATION OF THE MUCOUS MEMBRANE CONDITION IN THE TRANSITORY FOLD OF TEETH WITH CHRONIC APICAL PERIODONTITIS IN THE DYNAMICS OF COMPLEX ENDODONTIC TREATMENT

2019 ◽  
Vol 15 (3) ◽  
pp. 75-81 ◽  
Author(s):  
Алина Юсупова ◽  
Alina Yusupova ◽  
Лариса Герасимова ◽  
Larisa Gerasimova ◽  
Ирина Усманова ◽  
...  
Keyword(s):  
Mucous Membrane ◽  
Laser Doppler Flowmetry ◽  
Root Canal ◽  
High Efficiency ◽  
Apical Periodontitis ◽  
Endodontic Treatment ◽  
Laser Doppler ◽  
Control Group ◽  
Doppler Flowmetry ◽  
Periodontal Tissues

Subject. A sufficiently sensitive, high-resolution method of laser doppler flowmetry is used to characterize the сlaudication in the oral mucous membrane and periodontal tissues. This method makes it possible to detect early changes in the microcirculatory bloodstream and predict the course of chronic apical periodontitis. With the help of the method of laser doppler fluorometry, a comparative monitoring of the microcirculatory bloodstream of the mucous membrane of the transitory fold in the area of intact teeth and teeth with chronic apical periodontal was carried out. The aim of this study was efficiency determination of complex endodontic treatment of chronic apical periodontitis on the basis of monitoring the state of microcirculation of the mucous membrane in the transitory fold of the studied teeth. Methodology. Control group consisted of 55 patients with chronic apical periodontitis, and 20 patients with intact teeth aged 20 to 30 years old who underwent the analysis of microcirculation of the mucous membrane of the transitional fold of the studied teeth using laser doppler flowmetry (LDF). Results. The indicators IM, Kv, Q among 20 patients with intact teeth examined with the method of laser doppler flowmetry (LDF) were taken as normal. Studied parameters are significantly lower than normal in 55 patients with chronic apical periodontitis. In case of patients with chronic apical periodontitis, the inclusion of complex composed of the root canal system treatment by diode laser and the insertion into the root canal trombocytic autoplasma and its injection in projection of the root end in the protocol of endodontic treatment of chronic apical periodontitis helps to normalize microcirculation in the mucosa of the transitory folds of the investigated teeth. Summary. The study of the dynamics of the complex of endodontic treatment of chronic apical periodontitis showed its high efficiency (p≤0.001).

scholarly journals The Efficacy of Calcium Hydroxide Powder mixed with 0.2% Chlorhexidine Digluconate or mixed with Normal Saline as Intracanal Medicament in the Treatment of Apical Periodontitis

2015 ◽  
Vol 16 (8) ◽  
pp. 657-664 ◽  
Author(s):  
N Menakaya Ifeoma ◽  
C Adegbulugbe Ilemobade ◽  
H Oderinu Olabisi ◽  
P Shaba Olufemi
Keyword(s):  
Calcium Hydroxide ◽  
Normal Saline ◽  
European Society ◽  
Root Canal ◽  
Apical Periodontitis ◽  
Endodontic Treatment ◽  
Control Group ◽  
Chlorhexidine Digluconate ◽  
Quality Guidelines ◽  
Experimental Group

ABSTRACT Aim To compare the efficacy of calcium hydroxide powder mixed with 0.2% chlorhexidine digluconate or mixed with normal saline as intracanal medicament in the treatment of apical periodontitis. Materials and methods Subjects were 55 in number aged 17 to 60 years. Two-visit conventional root canal treatment was performed on 70 teeth. The teeth were divided by randomization (balloting) into two groups: control group and experimental group, each with 35 teeth treated with calcium hydroxide mixed with normal saline or with 0.2% chlorhexidine digluconate as intracanal medicament respectively. All treated teeth were evaluated clinically and radiographically for signs and symptom of periapical infection at specified periods postoperatively. Overall efficacy of medicament was rated based on quality guidelines for endodontic treatment by the European Society of Endodontology 2006. Results A postoperative favorable outcome of 97.1% in the control group and 94.3% in the experimental group was observed at 6-month review. This difference was not statistically significant (p > 0.05). Conclusion The use of normal saline or 0.2% chlorhexidine digluconate to mix calcium hydroxide used as intracanal medicament during endodontic treatment resulted in high postoperative favorable outcomes. Clinical significance Efficacy of 0.2% chlorhexidine digluconate as a vehicle for mixing calcium hydroxide as an intracanal medicament in the treatment of apical periodontitis is compa rable to the efficacy of calcium hydroxide mixed with normal saline. How to cite this article Menakaya IN, Adegbulugbe IC, Oderinu OH, Shaba OP. The Efficacy of Calcium Hydroxide Powder mixed with 0.2% Chlorhexidine Digluconate or mixed with normal Saline as Intracanal Medicament in the Treatment of Apical Periodontitis. J Contemp Dent Pract 2015;16(8):657-664.

scholarly journals Postoperative pain and antibacterial effect of 980 nm diode laser versus conventional endodontic treatment in necrotic teeth with chronic periapical lesions: A randomized control trial

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1795 ◽  
Author(s):  
Dina A. Morsy ◽  
Maged Negm ◽  
Alaa Diab ◽  
Geraldine Ahmed
Keyword(s):  
Postoperative Pain ◽  
Diode Laser ◽  
Root Canal ◽  
Bacterial Count ◽  
Endodontic Treatment ◽  
Control Group ◽  
Periapical Lesions ◽  
Anterior Teeth ◽  
Significant Difference ◽  
Aerobic And Anaerobic

Background: Many challenges encounter the endodontist, especially when dealing with necrotic teeth with chronic periapical lesions. Postoperative pain may be induced following conventional endodontic therapy and total eradication of the bacteria is almost unachievable even with recently available techniques. In recent years, diode laser usage in the endodontic field has gained acceptance. Thus, this study aimed to investigate the ability of the diode laser (DL) to decrease postoperative pain and achieve root canal sterility. Methods: 56 patients with anterior teeth with chronic periapical lesions in upper anterior teeth were randomly divided into two groups (n = 28). All patients were treated with two visits of conventional root canal treatment with ProTaper Universal. The DL group: root canals were irradiated with 200 µm fiber optic at both visits; the control group (Endo): the DL fiber was placed in root canal with no activation. Bacterial samples were collected from all the cases at each step of the treatment. Pain levels were evaluated using a numerical rating scale preoperatively, and after 6, 12, 24, 48 hours and 7 days. Bacterial count was used to detect both aerobic and anaerobic bacterial load.  Results: The qualitative pain scores revealed statistically significant lower pain levels in the DL group compared with the Endo group at all time intervals (P<0.001), except preoperatively where there was no significant difference. There was a statistically significant lower bacterial count for both aerobic and anaerobic bacteria in the DL group compared with the Endo group in both S3 samples (after laser application) and S4 samples (bacterial colonization) (P<0.001). Conclusion: The 980 nm diode laser may be a successful adjunct to conventional endodontic treatment of necrotic cases with chronic periapical lesions in terms of postoperative pain and root canal disinfection.   Trail registration: PACTR201511001275414 (date: 23rd September 2015)

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