Effect of Ultrasonic Activation of Bioceramic Sealer on Postoperative Pain in Lower Premolars

Inclusion Criteria: * Patients above 18 years old and to 50. * Male or female. * Patients seeking root canal treatment. * Mandibular posterior teeth with Symptomatic irreversible pulpitis with preoperative sharp, moderate, or severe pain with normal periapical radiographic appearance or slight widening in lamina dura. * Systematically healthy patient (ASA I, II). * Patient who can understand modified VAS and sign informed consent Exclusion Criteria: * Medically compromised patients having significant systemic disorders. (ASA III or IV). * History of intolerance to NSAIDS. * Patients with two or more adjacent teeth requiring endodontic treatment. * External root resorption. * Internal root resorption. * Vertical root fracture. * Periapical lesion. * Association with swelling. * Acute peri-apical abscess or acute exacerbation of a chronic abscess. * Pregnancy. * Use of ibuprofen in the last 12 hour. * Bleeding disorder. * Long term corticosteroid use. * Mobility Grade II or III. * Pocket depth more than 5mm. * Previous root canal therapy. * Non-restorability. * TMJ problems, bruxism, clenching or traumatic occlusion. * Inability to perceive the given instructions