Effect of Valaciclovir on Inter-Appointment Pain in Endodontic Treatment of Necrotic Teeth

Inclusion Criteria: * Patients between 18 and 60 years of age * Require primary root canal treatment (RCT) in single-rooted maxillary or mandibular teeth (anterior or posterior) * Diagnosed with symptomatic apical periodontitis (SAP) with confirmed pulp necrosis Exclusion Criteria: * Teeth with unrestorable crowns * Presence of endodontic-periodontal or pure endodontic lesions * Complex root canal anatomies as defined by the AAE Endodontic Case Difficulty Assessment Form * Internal or external root resorption * Calcified canals * Root canal configuration other than Vertucci's Type I * Pain originating from more than one tooth * Marginal periodontitis * Parafunctional habits * Systemic diseases classified as ASA class II or higher * Diagnosed migraine or other headache disorders mimicking orofacial pain * Intellectual or cognitive impairments * Pregnancy or breastfeeding * Use of medications affecting pain perception * Current use of antibiotics or antiviral agents * Known allergies to study medications