A randomized clinical comparative evaluation of interappointment flare-ups on placing Azadirachta indica, garlic, Triphala, and calcium hydroxide as intracanal medicament, in primary endodontic lesion.

Aim: The purpose of the study was to clinically evaluate interappointment flare-ups, on placing Azadirachta indica (neem), garlic (Allium sativum L.), Triphala, and calcium hydroxide (CH) as an intracanal medicament (ICM), using Verbal Rating Scale (VRS) in a patient with a primary endodontic lesion.

Methodology: Two hundred and forty patients indicated for root canal therapy were divided into two main groups as single-rooted teeth and multirooted teeth. Each group was further subdivided into four subgroups of 30 samples each. After the access opening, instrumentation was done as per the canal configuration. The herbal medicaments were prepared as an aqueous extract. The placement of ICM in the subgroups was randomly determined by computerized randomization. Interappointment flare-up and pain were assessed using VRS on 1, 3, 7, and 14 days.

Statistical analysis used: The intergroup comparisons of the incidence of flare-up were done using analysis of variance, followed by post hoc Tukey's test to test for the difference among individual groups.

Results: There was a statistically significant difference between the four groups, with P = 0.02 for multirooted teeth and 0.03 for single-rooted teeth. The post hoc Tukey's test showed the intergroup comparison of the flare-up incidence between garlic and Triphala to be statistically significant favoring Triphala, with P = 0.004 in single-rooted teeth and 0.008 in multirooted teeth.

Conclusion: Although there was no statistical significance between them, Triphala can be considered an alternative to CH as ICM. However, neem and garlic showed poor results.