The findings of a randomized controlled prospective study published in “Clinical Oral Investigations” indicated that calcium hydroxide mixed with lidocaine hydrochloride can be advantageous in alleviating postoperative pain in teeth with symptomatic apical periodontitis and irreversible pulpitis. Hakan Arslan et al. undertook this two-armed parallel clinical study to explore the impact of calcium hydroxide mixed with lidocaine hydrochloride on postsurgery spontaneous pain.

In total, 60 individuals suffering from pulpitis and apical periodontitis with preoperative spontaneous pain and percussion pain that was greater than 50 on a visual analogue scale (VAS) were incorporated. Following the root canal preparation, the participants were randomly assigned to either calcium hydroxide mixed with saline arm (n=30) or calcium hydroxide mixed with lidocaine hydrochloride (n = 30) arm.

For about a week every day, recording of the postsurgery spontaneous pain scores using a VAS was done. Using the chi-squared test, Mann-Whitney U tests, one-way analysis of variance, an assessment of the data was done. The calcium hydroxide mixed with lidocaine hydrochloride arm led to considerably diminished pain vs. the calcium hydroxide mixed with the saline group during days one to four (Figure 1).

Figure 1: Comparison of pain levels between the groups

Regarding the postsurgery percussion pain levels, no vital differences were noted between the arms. Thus, mixing calcium hydroxide with lidocaine hydrochloride can be valuable to minimize post-surgery pain in teeth with periodontitis and pulpitis.