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Abstract The aim of this study was to compare the effect of pulpotec and calcium hydroxide intracoronal dressing on inter-appointment pain relief for symptomatic posterior teeth with acute pulpitis with apical periodontitis. Results: The study resulted in after 8 hours and 12 hours, there was no difference between the two groups. After 24 hours, group B showed higher prevalence of no pain than group A, which showed higher prevalence of mild pain. After 48 hours, all cases had no pain. After 1 month, group B showed higher prevalence of no pain in comparison with group A, which showed higher prevalence of severe pain as all cases needed root canal treatment. Conclusion: pulpotec is considered successful as an intra-coronal dressing in relieving pain of acute pulpitis with apical periodontitis within 48 hours from the beginning of the procedure and up to 6 months postoperatively. Calcium hydroxide succeeded to relief the pain of acute pulpitis associated with apical periodontitis within the first 48 hours; however it failed to relief the pain over the follow up period |