1
|
Machado R, Moreira G, Comparin D, Barroso AP, Nascimento J, Ferraz CCR, Ignácio SA, da Fonseca Roberti Garcia L, Amaral RR, Shadid D, da Silva Neto UX. Postoperative pain after single-visit root canal treatments in necrotic teeth comparing instruments' kinematics and apical instrumentation limits - a prospective randomized multicenter clinical trial. BMC Oral Health 2024; 24:481. [PMID: 38643087 PMCID: PMC11032596 DOI: 10.1186/s12903-024-04225-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/04/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES This prospective randomized multicenter clinical trial (PRMCT) investigated postoperative pain after single-visit root canal treatments in teeth affected by pulp necrosis (PN), and asymptomatic apical periodontitis (AAP) (with apical radiolucent areas) or normal periradicular tissues (without apical radiolucent areas) comparing different instruments' kinematics and apical instrumentation limits. METHODS Before chemomechanical preparation, 240 patients/teeth were randomly distributed into four groups (n = 60) according to the instruments' kinematics (rotary or reciprocating) and apical instrumentation limits (with or without intentional foraminal enlargement [IFE]). After that, specimens were submitted to the same irrigation and obturation techniques, and the patients were referred to undergo the definitive restorations. No medication was prescribed, but the patients were instructed to take either paracetamol (750 mg every 6 h for three days) or ibuprofen (600 mg every 6 h for three days) in pain cases. Postoperative pain incidence and levels were assessed at 24-, 48-, and 72 h following treatment completion according to a verbal rating scale (VRS) following a score. The Kolmogorov-Smirnov test was applied to assess the normality of the data. Mann-Whitney U, Chi-square, Friedman's ANOVA, and Friedman's multiple 2 to 2 comparison tests were employed to identify potential significant statistical differences among the variables in the study groups (P < .05). RESULTS Significant statistical differences were only observed among the groups considering tooth, periradicular status, and the occurrence of overfilling (sealer extrusion) (P < 0.00). Patients with teeth instrumented through rotary kinematics and without IFE experienced lower rates of postoperative pain; however, this difference was relevant only at 24 h (P < 0.05). CONCLUSIONS Postoperative pain was lower after using a rotary file system (Profile 04) inserted up to the apical constriction (AC). However, this finding was just statistically meaningful at 24 h. TRIAL REGISTRATION This PRMCT was approved by the Human Research Ethics Committee of the Paranaense University - UNIPAR, Francisco Beltrão, PR, Brazil (CAAE. 46,774,621.6.0000.0109) on 02/09/2021. It was registered at The Brazilian Registry of Clinical Trials - ReBEC (RBR-3r967t) on 01/06/2023, was performed according to the Principles of the Helsinki Declaration and is reported following the Consolidated Standards of Reporting Trials Statement.
Collapse
Affiliation(s)
- Ricardo Machado
- College of Dentistry, Department of Restorative Sciences, Division of Endodontics, Health Sciences Center, University of Oklahoma - COD/OUHSC, Oklahoma City, Oklahoma, USA.
| | - Guilherme Moreira
- Clinical Practice Limited to Endodontics, Francisco Beltrão, Paraná, Brazil
| | - Daniel Comparin
- Clinical Practice Limited to Endodontics, Cunha Porã and Francisco Beltrão, Paraná, Brazil
| | - Arthur Pimentel Barroso
- Piracicaba Dental School, Department of Restorative Dentistry, Division of Endodontics, State University of Campinas - FOP/UNICAMP, Piracicaba, São Paulo, Brazil
| | - Jaqueline Nascimento
- School of Dentistry, Department of Endodontics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Caio Cézar Randi Ferraz
- Piracicaba Dental School, Department of Restorative Dentistry, Division of Endodontics, State University of Campinas - FOP/UNICAMP, Piracicaba, São Paulo, Brazil
| | - Sérgio Aparecido Ignácio
- School of Dentistry, Department of Statistics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry, Division of Endodontics, Federal University of Santa Catarina - UFSC, Florianópolis, Santa Catarina, Brazil
| | | | - David Shadid
- College of Dentistry, Department of Restorative Sciences, Division of Endodontics, Health Sciences Center, University of Oklahoma - COD/OUHSC, Oklahoma City, Oklahoma, USA
| | - Ulisses Xavier da Silva Neto
- School of Dentistry, Department of Endodontics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| |
Collapse
|
2
|
Kim DH, Choi YW, Kang S, Shin SJ, Jung IY. Postoperative pain of minimally invasive root canal treatment:a randomized clinical trial. Odontology 2024:10.1007/s10266-024-00912-6. [PMID: 38429393 DOI: 10.1007/s10266-024-00912-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/07/2024] [Indexed: 03/03/2024]
Abstract
This randomized clinical trial compared postoperative pain between a minimally invasive (MP) and conventional root canal treatment protocol (CP). A total of 170 mature permanent teeth (either with vital or necrotic pulp), were randomly assigned into two groups. In the CP group, ProTaper Gold (Dentsply Sirona, Ballaigues, Switzerland) and a continuous wave of condensation technique were used, whereas, in the MP group, TruNatomy (Dentsply Sirona), ultrasonic-assisted irrigation (UI), calcium hydroxide, and a sealer-based obturation technique were used. Patients recorded preoperative and postoperative pain using a 0-10 numerical rating scale (NRS) at 4 h, 1, 2, 3, 4, 5, 6, and 7 days after instrumentation and 1 day after canal obturation, respectively. There were no significant differences in pain intensity at any time points assessed between the two groups (p > 0.05). The occurrence of moderate/intense pain after instrumentation was significantly associated with preoperative periapical index (PAI) (p = 0.017) and NRS scores (p < 0.001). Preoperative pulp status (p = 0.009) and NRS score (p = 0.006) were identified as significant factors in the occurrence of moderate/intense pain after obturation. Instrumentation unequivocally reduced pain severity for both groups. The post-endodontic pain associated with the use of MP, combined with UI, Ca(OH)2, and calcium-silicate cement, did not differ from that of CP. Preoperative pain score, PAI, and preoperative pulp status were determined to be prognostic factors for postoperative pain.
Collapse
Affiliation(s)
- Do-Hyun Kim
- Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Sudaemun-gu, Seoul, 03722, Korea
| | - Yoon-Woo Choi
- Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Sudaemun-gu, Seoul, 03722, Korea
| | - Sumi Kang
- Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Sudaemun-gu, Seoul, 03722, Korea
| | - Su-Jung Shin
- Department of Conservative Dentistry, Gangnam Severance Dental Hospital, Yonsei University, Seoul, Korea
| | - Il-Young Jung
- Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Sudaemun-gu, Seoul, 03722, Korea.
| |
Collapse
|
3
|
Govindiah Chandra Mohan BG, Shivakumar D, Laxmi Penumaka S, Althaf S, Garg G, Kamatchi Subramani S. To Evaluate Different Endodontic Instrumentation Systems Regarding Post-Operative Pain After Endodontic Therapy: A Clinical Study. Cureus 2024; 16:e56466. [PMID: 38638716 PMCID: PMC11025581 DOI: 10.7759/cureus.56466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Despite substantial breakthroughs in instrumentation systems and pharmaceutical interventions, pain following endodontic therapy remains a serious concern. The effect of the type of endodontic instrumentation system in post-operative pain after endodontic therapy has been a matter of debate. AIM To evaluate different endodontic instrumentation systems, namely Reciproc (GmbH, Munich), OneShape® (MicroMega, France), Protaper Gold (Dentsply Sirona, USA), and Hyflex® EDM (Coltène/Whaledent Inc., USA) file systems, regarding post-operative pain after endodontic therapy Methods and materials: The endodontic department treated healthy patients aged 20 to 50 years who were experiencing symptoms of irreparable pulpitis in one or more maxillary molars or mandibular molars. Five hundred was the determined size of the sample. The study participants were divided into five categories, each comprising 100 participants. These categories were: Category 1: Reciproc instrumentation system. Category 2: OneShape® instrumentation system. Category 3: ProtaperGold instrumentation system. Category 4: HyFlex® EDM instrumentation system. Category 5: Control (stainless steel K-files). Following endodontic therapy, these scores were recorded at 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours using the VAS scale. RESULTS The visual analog scale (VAS) score (mean±SD) in the control group was 0.73± 0.40 (<0.001). The VAS score in the Reciproc group was 0.43± 0.05 (<0.001). The VAS score in the OneShape® group was 0.36±0.09 (<0.001). The VAS score in the Protaper Gold group was 0.41 ±0.08 (<0.001). The VAS score in the HyFlex® EDM group was 0.55 ±0.02 (<0.001). The VAS score in all instrumentation techniques at 72 hours follow-up was lesser in comparison to a control group with meaningful statistical significance (<0.001). However, the post-operative pain among the Reciproc, OneShape®, Protaper Gold, and HyFlex® EDM instrumentation systems was not different clinically when compared among themselves. However, VAS values were greater in OneShape® and HyFlex® EDM compared to Reciproc and Protaper Gold, showing increased post-operative pain in OneShape and HyFlex® EDM compared to Reciproc and Protaper Gold. It was also observed that there was a decline in the VAS score in all instrumentation systems as the follow-up period increased from 6 hours to 72 hours, with maximum post-operative pain at 6 hours of follow-up and minimum post-operative pain at 72 hours of follow-up. However, the decline was lesser in OneShape® and HyFlex® EDM in comparison to Reciproc and Protaper Gold, with increased post-operative pain in OneShape® and HyFlex® EDM in comparison to Reciproc and Protaper Gold. CONCLUSION Post-operative pain at all follow-ups of endodontic procedures was less in Reciproc, OneShape®, Protaper Gold, and HyFlex® EDM than in the control group. VAS scores were higher in the OneShape® and HyFlex® EDM groups compared to the Reciproc and Protaper Gold groups, indicating increased post-operative pain with OneShape® and HyFlex® EDM instruments in comparison to Reciproc and Protaper Gold.
Collapse
Affiliation(s)
| | - Disha Shivakumar
- Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College & Hospital, Bengaluru, IND
| | - Sravana Laxmi Penumaka
- Conservative Dentistry and Endodontics, Government Dental College and Hospital, Vijayawada, IND
| | - Shaik Althaf
- Conservative Dentistry and Endodontics, Oxford Dental College, Bangalore, IND
| | - Garima Garg
- Conservative Dentistry and Endodontics, Government Dental College and Hospital, Nagpur, IND
| | | |
Collapse
|
4
|
Fahim SZ, Ghali RM, Hashem AA, Farid MM. The efficacy of 2780 nm Er,Cr;YSGG and 940 nm Diode Laser in root canal disinfection: A randomized clinical trial. Clin Oral Investig 2024; 28:175. [PMID: 38403667 PMCID: PMC10894764 DOI: 10.1007/s00784-024-05563-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/14/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES Effective disinfection of the root canals is the cornerstone of successful endodontic treatment. Diminishing the microbial load within the root canal system is crucial for healing in endodontically treated teeth. The aim of this study was to evaluate the effect of 2780 nm Er,Cr:YSGG and 940 nm diode lasers on the eradication of microorganisms from single-rooted teeth with asymptomatic apical periodontitis. MATERIALS AND METHODS Thirty participants conforming to the inclusion criteria were randomly divided into 3 groups according to the disinfection protocol used; Conventional group: 2.5% Sodium Hypochlorite (NaOCl) and 17% EDTA solution NaOCl/EDTA, Dual laser group: 2780 nm Erbium, chromium: yttrium scandium-gallium-garnet (Er,Cr:YSGG) laser and 940 nm diode laser Er,CrYSGG/Diode, and Combined group: 17% EDTA and 940 nm diode laser EDTA/Diode. Bacterial samples were collected before and after intervention. The collected data were statistically analyzed using Friedman's test and Kruskal-Wallis test (P ≤ 0.05). RESULTS The results of the study showed that both dual laser Er,CrYSGG/Diode and combined laser EDTA/Diode groups showed significantly less mean Log10 CFU/ml of aerobic and anaerobic bacterial counts than the conventional NaOCl/EDTA group. CONCLUSIONS In this study we evaluated in vivo the bactericidal efficacy of three disinfection protocols for endodontic treatment of single-rooted teeth with apical periodontitis. The results indicated that both dual laser Er,CrYSGG/Diode and combined laser EDTA/Diode groups provide superior bactericidal effect compared to the conventional NaOCl/EDTA group. CLINICAL RELEVANCE The integration of lasers into root canal disinfection protocols has demonstrated significant bacterial reduction which might promote healing and long-term success.
Collapse
Affiliation(s)
- Sara Zakaria Fahim
- Faculty of Dentistry, Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Future University, Cairo, Egypt.
| | - Rami Maher Ghali
- Faculty of Dentistry, Department of Prosthodontics, Ain Shams University, Cairo, Egypt
| | - Ahmed A Hashem
- Ain Shams University, Faculty of Dentistry, Endodontic Department, Cairo, Egypt
- Cleveland Dental Institute, Cleveland, OH, USA
| | - Mary Medhat Farid
- Faculty of Dentistry, Department of Oral and Maxillofacial, Radiology, Ain Shams University, Cairo, Egypt
| |
Collapse
|
5
|
Brochado Martins JF, Jautze A, Georgiou AC, Tulp BMT, Crielaard W, van der Waal SV. Well-being, postoperative pain and outcome after clinical application of a novel root canal irrigation fluid-RISA-in teeth with apical periodontitis: A first-in-human study. Int Endod J 2023; 56:1488-1498. [PMID: 37771316 DOI: 10.1111/iej.13977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/31/2023] [Indexed: 09/30/2023]
Abstract
AIM The aim of the study was to assess the tolerance to the new root canal irrigation fluid RISA after root canal treatment (RCT) by evaluating the subject's postoperative well-being, postoperative pain (PP) and treatment outcome. METHODOLOGY A single-arm prospective study with 16 subjects (17 teeth) diagnosed with asymptomatic apical periodontitis. Endodontic treatment in one session performed using RISA for root canal irrigation. Well-being was assessed on the same day and after 24 h by telephone. For pain intensity, a visual analogue scale was used at 0-5 days. Clinical and radiographic evaluations were performed at ≥12 months. Well-being, occurrence of PP and outcome were qualitatively reported. Friedman test for paired samples and Spearman correlation coefficient were used. Significance was set at p < .05. RESULTS At the same day and after 24 h, 14/16 subjects felt 'good'. 9/16 presented intra- or extra-oral swelling. The frequency of PP ≥36 (weak) was 82.4%. On the same day, 1 and 2 days postoperatively, there was more pain compared with preoperative pain p < .05. At Day 3, PP equalled preoperative pain (p > .05). 62.5% of subjects needed analgesics Day 0-2. The recall rate was 94.1%, and resolution of apical periodontitis was observed in 87.5%. CONCLUSIONS The well-being of subjects was good, and the overall PP intensity was low. However, postoperative intra- and extra-oral swelling occurred often. At the recall visit, the effectiveness of the RCT with RISA appeared high (87.5%). The encouraging outcome results plus the fact that RISA has a broader action range than NaOCl in vitro, justify further work on the RISA solution. To reduce postoperative swelling, it is advised to further investigate the optimal way of application of RISA in the laboratory before clinical application is recommended.
Collapse
Affiliation(s)
- João Filipe Brochado Martins
- Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Anthony Jautze
- Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Athina Christina Georgiou
- Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Birgitte Maria Theresia Tulp
- Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Wim Crielaard
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Suzette Veronica van der Waal
- Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
6
|
Palanisamy R, Anirudhan S, Roja RJS, Koshy M. Comparison of ultrasonic versus side-vented needle irrigation for reductions in bacterial growth and postoperative pain: A randomized controlled trial. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2023; 26:616-620. [PMID: 38292745 PMCID: PMC10823969 DOI: 10.4103/jcde.jcde_61_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/07/2023] [Accepted: 09/21/2023] [Indexed: 02/01/2024]
Abstract
Background Postoperative pain affects 16%-25% of root canal therapy patients. The irrigating system and irrigants used should reduce bacterial load without irrigant extrusion beyond the root canal apex, potentially reducing postoperative pain and discomfort. Aim This study aims to compare the effects of passive ultrasonic irrigation and side-vented needle irrigation on postoperative pain and bacterial load in single-rooted teeth with pulp necrosis. Materials and Methods Eighty patients with pulpal necrosis in single-rooted teeth were randomly categorized into two groups (n = 40 each): Group A (side-vented needle irrigation) and Group B (passive ultrasonic irrigation). Bacterial samples were collected using sterile paper points after initial access cavity preparation (S1) and standard endodontic instrumentation + irrigation (S2). Bacterial growth was assessed on MacConkey and blood agar. Pain was recorded 30 min preoperatively and 6, 12, 24, and 48 h postoperatively. Statistical Analysis Used Chi-square test, independent t-test and paired t-test. Results Irrigation with Irrisafe tips showed increased number of bacteria-free samples and a significant reduction in postoperative pain (at the 6 and 12 h time-points) when compared to side-vented needle. Conclusions Passive ultrasonic irrigation with Irrisafe tips may be more effective than side-vented needle irrigation in reducing postoperative pain and intracanal bacterial load in patients undergoing endodontic treatment.
Collapse
Affiliation(s)
- Revathi Palanisamy
- Department of Conservative Dentistry and Endodontics, Sri Ramakrishna Dental College and Hospital, Dr. TNMGRM University, Coimbatore, Tamil Nadu, India
| | - Subha Anirudhan
- Department of Conservative Dentistry and Endodontics, Sri Ramakrishna Dental College and Hospital, Dr. TNMGRM University, Coimbatore, Tamil Nadu, India
| | - R. Jaya Shree Roja
- Department of Conservative Dentistry and Endodontics, Sri Ramakrishna Dental College and Hospital, Dr. TNMGRM University, Coimbatore, Tamil Nadu, India
| | - Minu Koshy
- Department of Conservative Dentistry and Endodontics, Sri Ramakrishna Dental College and Hospital, Dr. TNMGRM University, Coimbatore, Tamil Nadu, India
| |
Collapse
|
7
|
Elheeny AAH, Sermani DI, Abdelmotelb MA. Postoperative pain perception and associated risk factors in children after continuous rotation versus reciprocating kinematics: A randomised prospective clinical trial. AUST ENDOD J 2023; 49 Suppl 1:345-352. [PMID: 37026535 DOI: 10.1111/aej.12746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 04/08/2023]
Abstract
To compare the postoperative pain of continuous rotation and reciprocating movements after pulpectomy of non-vital primary molars and determine associated risk factors. 146 children aged 4-8 years with one primary molar indicated for pulpectomy were randomly assigned to two equal groups: those instrumented with continuous rotation motion (Hyflex EDM Coltene/Whaledent) and reciprocating motion (Reciproc R25 (VDW)). A 4-point pain scale was used to assess postoperative pain frequencies, which were compared at different intervals using the Chi-square test. Postoperative pain risk factors were determined using logistic regression analysis. There was no statistically significant difference between the follow-ups. Gender, pulp status, and radiographic radiolucency increased the risk of postoperative pain incidence. Postoperative pain likelihood in children with chronic apical periodontitis was 8.72 times that of children with necrotic pulps. Postoperative pain after instrumentation with both kinematics was comparable. Postoperative pain incidence is increased by preoperative pulp condition, radiographic radiolucency, and gender.
Collapse
Affiliation(s)
- Ahmad Abdel Hamid Elheeny
- Department of Paediatric and Community Dentistry, Faculty of Dentistry, Minia University, El Minia, Egypt
| | - Dania Ibrahem Sermani
- Department of Paediatric Dentistry, Faculty of Dentistry, Minia University, El Minia, Egypt
- Intern at Minia University Minia Hospital, Minia University, El Minia, Egypt
| | | |
Collapse
|
8
|
Agrawal A, Agrawal N, Biswas K, Vasisth D, Almutairi N, Alotaibi BB, Patel B, Singh R. Evaluation of the Impact of Different Instrumentation Techniques on the Incidence of Postoperative Pain in Patients Undergoing Root Canal Treatment. Cureus 2023; 15:e42736. [PMID: 37654945 PMCID: PMC10467327 DOI: 10.7759/cureus.42736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Postoperative pain is a common concern in root canal treatment, and the choice of instrumentation technique can significantly impact patient comfort. This study aimed to evaluate the impact of different instrumentation techniques on the incidence of postoperative pain in patients undergoing root canal treatment. METHODS A randomized controlled trial was conducted on 208 patients randomly assigned to four groups: step-back preparation, crown-down preparation, hybrid technique, and conventional instrumentation. Pain intensity was assessed using a verbal rating scale (VRS) at six, 12, 24, 48, and 72 hours postoperatively. Data were analyzed using appropriate statistical methods. RESULTS The mean pain scores and standard deviations (SDs) were calculated for each instrumentation technique at different time intervals. At six hours, the step-back preparation group reported a mean pain score of 2.3 (SD = 0.8), the crown-down preparation group had a score of 2.8 (SD = 0.9), the hybrid technique group had a score of 2.5 (SD = 0.7), and the conventional instrumentation group had a score of 3.1 (SD = 0.1). The differences in pain scores between the groups were statistically significant at all time intervals (p < 0.05). CONCLUSION The choice of instrumentation technique significantly influenced the incidence of postoperative pain in root canal treatment. The step-back preparation technique was associated with lower pain intensity than the crown-down preparation, hybrid technique, and conventional instrumentation. These findings highlight the importance of considering the instrumentation technique to optimize patient comfort during and after root canal treatment.
Collapse
Affiliation(s)
- Ankita Agrawal
- Department of Endodontics and Conservative Dentistry, Buddha Institute of Dental Sciences and Hospital, Patna, IND
| | - Neha Agrawal
- Department of Dentistry, Government Medical College, Mahasamund, IND
| | - Krishna Biswas
- Department of Conservative Dentistry and Endodontics, All India Institute of Medical Sciences, Guwahati, IND
| | - Diwakar Vasisth
- Department of Dental and Maxillofacial Surgery, Lady Hardinge Medical College and Hospital, Delhi, IND
| | - Nawaf Almutairi
- Department of Conservative Dental Science and Endodontics, Qassim University, Buraidah, SAU
| | - Badi B Alotaibi
- Department of Conservative Dental Science, Qassim University, Buraidah, SAU
| | - Bhumika Patel
- Department of Oral Medicine and Radiology, Howard University, Washington, DC, USA
| | - Ramanpal Singh
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, IND
| |
Collapse
|
9
|
Park SR, Park SH, Cho KM, Kim JW, Kim HC. Patient discomfort levels during instrumentation procedure using nickel-titanium files with different kinetic movements. AUST ENDOD J 2022; 48:372-379. [PMID: 34813131 DOI: 10.1111/aej.12590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 12/14/2022]
Abstract
This study evaluated the perceived vibration, noise and discomfort levels associated with two nickel-titanium file systems with different kinetics; reciprocating motion (REC) using WaveOne Gold and continuous rotation motion (CON) using ProTaper NEXT. Forty roots with two canals from maxillary premolar and molar of 40 patients were included. Root canals were instrumented using each system for each canal. Patients were surveyed about the vibration, noise and discomfort experienced using visual analogue scale, and their preference. The responses were statistically analysed using Wilcoxon Signed-Rank test, Mann-Whitney U test and Spearman's rank correlation test at the 95% of significance level. The vibration, noise and discomfort experienced were significantly greater in REC than CON (P < 0.05). In REC, male subjects reported significantly higher vibration than female (P < 0.05). Majority respondents (72.5%) preferred the CON method. The perceived vibration, noise and discomfort were less apparent from the CON than the REC.
Collapse
Affiliation(s)
- So-Ra Park
- Department of Conservative Dentistry, School of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Se-Hee Park
- Department of Conservative Dentistry, School of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Kyung-Mo Cho
- Department of Conservative Dentistry, School of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Jin-Woo Kim
- Department of Conservative Dentistry, School of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea
| |
Collapse
|
10
|
Elheeny AAH, Abdelmotelb MA. Postoperative pain after primary molar pulpectomy using rotary or reciprocating single files: A superior, parallel, randomized clinical trial. Int J Paediatr Dent 2022; 32:819-827. [PMID: 35152509 DOI: 10.1111/ipd.12959] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/30/2022] [Accepted: 02/09/2022] [Indexed: 11/29/2022]
Abstract
AIM To compare postoperative pain intensity between two single-file systems with different kinetics (the OneShape file with continuous rotation vs. the WaveOne Gold file with reciprocation movement) after primary molar pulpectomy. DESIGN This superiority, parallel, randomized clinical trial included 164 healthy children aged 6 to 8 years with asymptomatic, necrotic, maxillary primary second molars due to caries. An equal number of children were assigned to the two groups. The teeth of children in Group 1 were instrumented with the OneShape rotary system (Micro-Mega), whereas teeth of children in Group 2 were instrumented with the WaveOne Gold reciprocating system (Dentsply Maillefer). Postoperative pain intensity was assessed using a 4-point pain scale at 6, 12, 24, 48 and 72 h and 1 week after treatment. The parent of each participant received 6 flashcards that included four faces and a word describing each face. A chi-square test was used to compare postoperative pain intensity. The level of significance was set to 5%. RESULTS Over the follow-up period, no significant difference in postoperative pain intensity was found between the two groups (p > .05). Although the absolute risk reduction maximum limit of 95% CI equal or exceeded the predetermined proportional difference of 0.15, pain intensity was inconclusive at 6, 24, and 48 hours denoting that the superiority of the OneShape single-file over the WaveOne Gold single-file could not be declared. CONCLUSIONS Postoperative pain intensity associated with a rotary vs. reciprocating file system was nearly similar.
Collapse
|
11
|
Koçer A, Dönmez Özkan H, Turk T. Postoperative pain intensity and incidence following single visit root canal treatment with different obturation techniques: a randomized clinical trial. PeerJ 2022; 10:e13756. [PMID: 35915749 PMCID: PMC9338753 DOI: 10.7717/peerj.13756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/28/2022] [Indexed: 01/17/2023] Open
Abstract
Background There are few studies in the literature about the effect of obturation techniques on postoperative pain. Besides, GuttaFlow2 was used for the first time in this study regarding postoperative pain. This study aimed to compare the postoperative pain levels and incidence following single-visit root canal treatment with different canal filling techniques; cold lateral compaction (CLC), thermoplasticised solid-core carrier (GuttaCore) based filling and cold free-flow compaction (GuttaFlow2) technique. Methods The patients (n = 93) having single-rooted teeth with a single canal diagnosed with asymptomatic irreversible pulpitis or single-rooted vital teeth with a single canal requiring endodontic treatment because of prosthetic reasons were enrolled in this study. Patients were randomized into three groups (n = 31) according to the obturation technique. A single operator performed all the treatments in a single visit. Data on obturation levels, postoperative pain and analgesic intake frequency were recorded at postoperative 6, 12 and 24 h and daily afterward until the 7th day. Postoperative pain was measured by visual analogue scale (VAS). The date were statistically analyzed with chi-squared tests (for the analyses of the categorical data), the nonparametric Kruskal-Wallis test (for the comparisons of VAS score) and with the Friedman test (for the assessments of the changes in VAS scores over time). Results The GuttaCore group recorded the higher pain levels, except first 12 h, on the other hand, the GuttaFlow2 group recorded the lower pain levels at all time periods. Significant differences occurred among the groups during the first 4 days (p < 0.05), except at 12 h (p = 0.054). The patients in the CLC and GuttaFlow2 groups did not need to use the prescribed analgesic; however, one patient in the GuttaCore group used it once. Conclusions Postoperative pain levels following root canal therapy were affected by the obturation technique especially first 4 days following obturation.
Collapse
Affiliation(s)
- Aliye Koçer
- Department of Endodontics, Aydın Adnan Menderes University, Efeler, Aydın, Türkiye
| | - Hicran Dönmez Özkan
- Department of Endodontics, Aydın Adnan Menderes University, Efeler, Aydın, Türkiye
| | - Tugba Turk
- Department of Endodontics, Ege University, Bornova, İzmir, Türkiye
| |
Collapse
|
12
|
Oliveira PS, Ferreira MC, Paula NGN, Loguercio AD, Grazziotin-Soares R, da Silva GR, da Mata HCS, Bauer J, Carvalho CN. Postoperative Pain Following Root Canal Instrumentation Using ProTaper Next or Reciproc in Asymptomatic Molars: A Randomized Controlled Single-Blind Clinical Trial. J Clin Med 2022; 11:jcm11133816. [PMID: 35807101 PMCID: PMC9267392 DOI: 10.3390/jcm11133816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 02/04/2023] Open
Abstract
Aim: The development of postoperative pain following root canal instrumentation may impair patient’s comfort and undermine their trust in the dentist. This study assessed the effect of root canal instrumentation techniques (rotary (PTN; ProTaper Next®) and reciprocating (R; Reciproc®)) on the postoperative pain intensity (primary outcome) and tenderness on biting (secondary outcome) of patients’ asymptomatic molars. Methodology: This study protocol was registered with ReBec-WHO (U1111-1182-2800). From a pool of 112 patients evaluated for eligibility (healthy adults (≤18 years old)), with a single asymptomatic molar (maxillary or mandibular) indicated for root canal treatment, diagnosed with asymptomatic irreversible pulpitis (including chronic hyperplastic pulpitis), 75 were randomly allocated in similar proportions to receive the intervention (two-appointment root canal therapy) in either the PTN or R group. The allocated procedures were performed using standardized protocols. Participants (blinded to the instrumentation technique) rated their pain intensity at 6, 12 and 24 h and from day 2 to day 7 following the root canal instrumentation appointment using a VAS and an NRS; the ibuprofen tablets taken and the presence of tenderness on biting were recorded. The instrumentation time was registered. Univariate and multivariate statistics measured the effect of independent variables on the outcomes. Results: From the 75 patients allocated, 8 patients (4 from each group) were lost; in total, 33 patients were analyzed in the PTN group and 34 in the R group. The frequencies of postoperative pain (p > 0.05) and tenderness on biting (p > 0.05) were similar between groups. The medication intake (mean of 1.31 tablets) and the time of instrumentation (approximately 11 min) were similar between groups. Conclusion: ProTaper Next and Reciproc® caused a slight risk of tenderness on biting and contributed to similar self-reported postoperative pain (low intensity) up to 7 days following root canal shaping.
Collapse
Affiliation(s)
- Patrícia Santos Oliveira
- Postgraduate Program of Dentistry, CEUMA University, São Luís 65065-470, Brazil; (P.S.O.); (M.C.F.); (N.G.N.P.)
| | - Meire Coelho Ferreira
- Postgraduate Program of Dentistry, CEUMA University, São Luís 65065-470, Brazil; (P.S.O.); (M.C.F.); (N.G.N.P.)
| | | | - Alessandro Dourado Loguercio
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa 84010-330, Brazil;
| | | | - Gisele Rodrigues da Silva
- Department of Operative Dentistry, Federal University of Uberlândia (UFU), Uberlândia 38408-100, Brazil;
| | | | - José Bauer
- Dentistry Biomaterials Laboratory (Biomma), School of Dentistry, Federal University of Maranhão, São Luís 65080-805, Brazil;
| | - Ceci Nunes Carvalho
- Postgraduate Program of Dentistry, CEUMA University, São Luís 65065-470, Brazil; (P.S.O.); (M.C.F.); (N.G.N.P.)
- Correspondence: ; Tel.: +55-98-98117-0078
| |
Collapse
|
13
|
Spohr AR, Xavier SR, Malta CP, Pereira-Cenci T, Pappen FG, Morgental RD. Postoperative pain after endodontic reintervention: a randomized clinical trial. Braz Dent J 2022; 33:18-27. [PMID: 35766713 PMCID: PMC9645201 DOI: 10.1590/0103-6440202204785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/28/2022] [Indexed: 12/01/2022] Open
Abstract
The present randomized clinical trial compared the prevalence and intensity of
postoperative pain in cases of endodontic reintervention using manual or
engine-driven reciprocating instruments. As secondary objectives, the analgesic
intake and time required for the root canal filling removal and
re-instrumentation were also evaluated. Forty-eight individuals with an
endodontically treated single-rooted tooth diagnosed with asymptomatic apical
periodontitis were included in the study. Patients were randomly assigned to two
comparison groups (n=24/group): reintervention with stainless steel manual
instruments or a nickel-titanium reciprocating system (Reciproc; VDW, Munich,
Germany). The endodontic reintervention was performed in two sessions with a
calcium hydroxide-based intracanal medication applied for 14 days before root
canal obturation. Working time for the root canal filling removal and
re-instrumentation was recorded with a digital stopwatch. After each visit,
postoperative pain intensity was assessed at 12, 24, and 48 hours and seven days
using the Numerical Rating Scale (NRS). The patients were also asked about
analgesic intake. Data were analyzed using Pearson chi-square, T and
Mann-Whitney U tests (α=0.05). No significant differences between groups were
found regarding the prevalence and intensity of pain or the need for analgesic
intake at any time point (P > 0.05). Working time was significantly shorter
in the reciprocating group (18 versus 41 minutes). In conclusion, manual and
reciprocating instruments achieved the same results in terms of prevalence and
intensity of postoperative pain and analgesic intake. However, filling material
removal and re-instrumentation of the root canals were more than twice as fast
when using the reciprocating system.
Collapse
Affiliation(s)
- Andressa Raquel Spohr
- Graduate Program in Dentistry, Federal University of Pelotas(UFPel), Pelotas, RS, Brazil
| | | | - Cristiana Pereira Malta
- Graduate Program in Dental Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Tatiana Pereira-Cenci
- Graduate Program in Dentistry, Federal University of Pelotas(UFPel), Pelotas, RS, Brazil
| | | | | |
Collapse
|
14
|
Arias A, Peters OA. Present Status and Future Directions - Canal Shaping. Int Endod J 2022; 55 Suppl 3:637-655. [PMID: 35118683 PMCID: PMC9303733 DOI: 10.1111/iej.13698] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 12/01/2022]
Abstract
This narrative review will focus on the evolution, present and future of engine‐driven root canal preparation. Root canal preparation changed drastically when Walia in 1988 introduced the use of nickel‐titanium (NiTi) alloys in Endodontics. In 2013, five generations of NiTi endodontic instruments had been established based on their metallurgical, mechanical properties and design features. Since then, manufacturers have been introducing further major changes in instrument design and characteristics that have not been translated in new recognized generations of instruments. In general, those changes have demonstrated enhanced instrument properties, but it is not clear yet if all those improvements are directly translated to an improvement in clinical success. This narrative review attempts to address the present status of engine‐driven instruments in terms of both evidence from laboratory‐based studies and clinical data, to identify potential further generations of instruments, and last to anticipate future directions for research and development.
Collapse
Affiliation(s)
- A Arias
- School of Dentistry, Complutense University, Madrid, Spain
| | - O A Peters
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
| |
Collapse
|
15
|
Shaik RP, Chukka RS, Bandlapally A, Vemuri S, Bolla N, Basam RC, Tammineedi S. Assessment of postoperative pain after single-visit root canal treatment using rotary and reciprocating file systems: an in vivo study. J Dent Anesth Pain Med 2022; 22:267-275. [PMID: 35991361 PMCID: PMC9358273 DOI: 10.17245/jdapm.2022.22.4.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/28/2022] [Accepted: 07/08/2022] [Indexed: 11/26/2022] Open
Abstract
Background Various instrument kinematics used in single-visit endodontics influence the occurrence of pain after endodontic therapy. This study aimed to evaluate the occurrence of pain after mechanical instrumentation with Hyflex EDM (HEDM) and WaveOne Gold (WOG) during single-visit endodontic therapy. Methods Sixty patients diagnosed with asymptomatic irreversible pulpitis and normal apical tissues in mandibular premolar teeth were included in the study for single-visit root canal therapy. The patients were divided into two groups (n = 30) according to the rotary instrument used during root canal preparation (group A [HEDM] and group B [WOG]). Pain was evaluated after endodontic therapy at 8, 24, and 48 h intervals using the visual analog scale (VAS). Data obtained were analyzed using the chi-square test, independent t-test, MannWhitney U test, and Wilcoxon matched-pairs test. Results Statistically significant differences were observed between the two groups (P < 0.001) at 8, 24, and 48 h, with WOG exhibiting less pain than HEDM files. Conclusion Postoperative pain was lower in the WOG file system than in the HEDM file system after single-visit root canal therapy at 8, 24, and 48 h.
Collapse
Affiliation(s)
- Reshma Parveen Shaik
- Department of Conservative Dentistry and Endodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Ram Sunil Chukka
- Department of Conservative Dentistry and Endodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Anila Bandlapally
- Department of Conservative Dentistry and Endodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Sayesh Vemuri
- Department of Conservative Dentistry and Endodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Nagesh Bolla
- Department of Conservative Dentistry and Endodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Ram Chowdary Basam
- Department of Conservative Dentistry and Endodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Sravanthi Tammineedi
- Department of Conservative Dentistry and Endodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| |
Collapse
|
16
|
Atesci AA, Topaloglu-Ak A, Turan E, Oncag O, Kaval ME. Evaluation of Postoperative Pain Following Single-Visit Root Canal Treatment with Rotary and Reciprocal Ni–Ti File Systems in Children. Medicina (B Aires) 2021; 58:medicina58010050. [PMID: 35056358 PMCID: PMC8780144 DOI: 10.3390/medicina58010050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 12/05/2022] Open
Abstract
Background and Objectives: Postoperative pain is a common symptom of a flare-up after root canal treatments (RCTs). Insufficient instrumentation, extrusion of irrigation solutions and debris, and the existence of a periapical lesion are the factors affecting postoperative pain after root canal treatments. The aim of this study was to evaluate the postoperative pain and instrumentation time of the single-file reciprocating system and multiple-file Ni–Ti rotary system in children ages 9–12 years old. Materials and Methods: Our study was conducted on 51 permanent mandibular molars with the diagnosis of irreversible pulpitis. Patients were randomly assigned into two groups, and RCTs were completed with either the Reciproc Blue or Protaper NEXT file systems. Instrumentation time for each system was noted, and patients were given a pain scale that included a visual analog scale for 6, 24, 48, and 72 h after treatment. Postoperative pain scores and instrumentation times were analyzed statistically with a chi-square test and Student’s t-test. Results: There was no statistically significant difference in postoperative pain between the Reciproc Blue and Protaper NEXT systems at all time intervals. Instrumentation time was significantly shorter in the Reciproc Blue group in comparison with the Protaper NEXT group. Conclusions: Postoperative pain findings following RCT using single-file reciprocating systems were similar to the rotary system group. However, chair time in the reciprocating system group was significantly lower. This provided a comfortable and patient-friendly treatment approach for children, and could enhance their cooperation.
Collapse
Affiliation(s)
| | - Aslı Topaloglu-Ak
- Department of Pediatric Dentistry, School of Dentistry, Istanbul Aydın University, Istanbul 34295, Turkey
- Correspondence:
| | - Ece Turan
- Independent Researcher, Izmir 35220, Turkey; (A.A.A.); (E.T.)
| | - Ozant Oncag
- Department of Pediatric Dentistry, School of Dentistry, Ege University, Izmir 35040, Turkey;
| | - Mehmet Emin Kaval
- Department of Endodontics, School of Dentistry, Ege University, Izmir 35040, Turkey;
| |
Collapse
|
17
|
Alves-Silva EG, Arruda-Vasconcelos R, Louzada LM, de-Jesus-Soares A, Ferraz CCR, de Almeida JFA, Marciano MA, Steiner-Oliveira C, Bello-Silva MS, Shemesh H, Paula Figueiredo de Almeida Gomes B. The effect of photodynamic therapy on postoperative pain in teeth with primary endodontic infection. Photodiagnosis Photodyn Ther 2021; 37:102700. [PMID: 34954090 DOI: 10.1016/j.pdpdt.2021.102700] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The objective of this study was to investigate the action of photodynamic therapy on pain control after endodontic treatment in asymptomatic teeth with a primary infection, within a single visit. METHODS Sixty (60) single-rooted teeth with pulp necrosis and periapical lesions were selected and randomly divided into two (2) groups (n=30), according to the protocol; a control group (CG) and a group using photodynamic therapy (aPDT). The canals were instrumented with Reciproc files # 25 up to 40 along the entire length of the canal, using 2% chlorhexidine gel as the auxiliary chemical substance, followed by irrigation with sterile saline. The canals were filled with Endomethasone N cement, 0.005% methylene blue, using AsGaAl diode laser, 660 nm wavelength, 100 mW of power and 9 J of energy, using optical fibers with 365 µm in diameter. RESULTS Pain intensity was assessed at 8, 12, 24, 48, 72 hours and 1 week after endodontic treatment using a visual analogue scale. The level of pain was classified as none (0), mild (1-3), moderate (4-7) or severe (8-10). The data were at a significance level of 5%. There was a statistically significant difference (p<0.05) in the periods of 8, 12, 24, 48 and 72 hours between the control group and the aPDT group. After 1 week, there was no statistically significant difference. CONCLUSIONS It is concluded that photodynamic therapy had a significant effect on decreasing post-endodontic treatment pain in teeth with necrotic pulp and asymptomatic periapical lesions.
Collapse
Affiliation(s)
- Esdras Gabriel Alves-Silva
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Rodrigo Arruda-Vasconcelos
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Lidiane Mendes Louzada
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Caio Cezar Randi Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - José Flávio Affonso de Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Marina Angélica Marciano
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Carolina Steiner-Oliveira
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Marina Stella Bello-Silva
- Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | - Hagay Shemesh
- Department of Endodontology, Academic Centre for Dentistry of Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands..
| | | |
Collapse
|
18
|
Hülsmann M. A critical appraisal of research methods and experimental models for studies on root canal preparation. Int Endod J 2021; 55 Suppl 1:95-118. [PMID: 34800299 DOI: 10.1111/iej.13665] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/17/2021] [Indexed: 01/02/2023]
Abstract
It is the aim of this review to present a critical overview and summary on the contemporary possibilities, limitations and challenges of research related to root canal preparation. Frequently used research tools and contemporary research designs will be presented and discussed critically focussing on shortcomings and benefits with special regard to clinical relevance and scientific evidence. A plethora of experimental set-ups for assessing the shaping of root canals have been described in the endodontic literature using a considerable number of techniques and instruments. Nevertheless, it can be stated that scientific evidence demonstrating the clinical impact of many investigated topics is questionable or even missing. Instead of technical, radiographic and geometrical parameters, further research should focus on biological aspects and clinical evidence of the impact of root canal preparation on the outcome of root canal treatment.
Collapse
Affiliation(s)
- Michael Hülsmann
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| |
Collapse
|
19
|
Eliasz W, Czarnecka B, Surdacka A. Apical Extrusion of Debris during Root Canal Preparation with ProTaper Next, WaveOne Gold and Twisted Files. MATERIALS 2021; 14:ma14216254. [PMID: 34771780 PMCID: PMC8585032 DOI: 10.3390/ma14216254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 12/25/2022]
Abstract
(1) Background: Apical extrusion of debris is an example of a complication that may arise during root canal treatment, and it has been proven to be an unavoidable occurrence during endodontic treatment by numerous authors. Even though it may not hinder the long-term outcome of treatment, it may lead directly to increased levels of postoperative pain and, therefore, lower levels of patient acceptance and satisfaction. The aim of the study was to assess the weight of apically extruded debris during root canal preparation with instruments that use different movement kinematics (rotary, reciprocating, and adaptive motion); (2) Methods: The study was performed using the Myers and Montgomery model. Sixty human premolar teeth were inserted into preweighed Eppendorf tubes and randomly classified into three groups. After manual glide-path preparation, teeth in each group were instrumented to working length set 1 mm short of the anatomical apex using the standard sequence provided by the manufacturers (for Group 1: ProTaper Next X1 & X2; for Group 2: WaveOne Gold Primary, for Group 3: Twisted Files SM1-SM3). Root canals were irrigated with 1 mL of 0.9% NaCl solution between each file insertion. The tubes with collected debris were stored in an incubator at 70 °C for 5 days in order to evaporate the liquid component. Measurement of the weight of extruded debris was performed by subtracting the preinstrumentation from the postinstrumentation weight of the tubes. The results were analyzed with Kruskal-Wallis ANOVA, with significance level set at 0.05; (3) Results: The weight of extruded debris was 0.337 mg (SD = 0.148) for Group 1, 0.305 mg (SD = 0.201) for Group 2, and 0.348 mg (SD = 0.135) for Group 3. (4) Conclusions: Engine-driven root canal preparation with the use of instruments ProTaper Next, WaveOne Gold and Twisted Files that use different movement kinematics (rotary, reciprocating, and adaptive motion) was associated with apical extrusion of debris to a similar extent.
Collapse
Affiliation(s)
- Wojciech Eliasz
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
- Correspondence: ; Tel.: +48-732-571-657
| | - Beata Czarnecka
- Department of Biomaterials and Experimental Dentistry, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| |
Collapse
|
20
|
Ozlek E, Gunduz H, Kadi G, Taşan A, Akkol E. The effect of solution and gel forms of sodium hypochlorite on postoperative pain: a randomized clinical trial. J Appl Oral Sci 2021; 29:e20200998. [PMID: 34406315 PMCID: PMC8360624 DOI: 10.1590/1678-7757-2020-0998] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/21/2021] [Indexed: 01/20/2023] Open
Abstract
Objectives The aim of this study is to evaluate the effect of using gel and solution forms of NaOCI during the chemomechanical preparation of the root canals on postoperative pain at different time intervals. Methodology 114 patients with mandibular molar teeth and symptomatic irreversible pulpitis were included in the study. All patients were divided into two groups based on the irrigant used during root canal preparation (n=57): Group 1, 5.25% NaOCI, Group 2, 5.25% NaOCI gel. All groups were filled with gutta-percha and AH Plus root canal sealer using single-cone technique. VAS scale (1-10) was used for postoperative pain assessment. After endodontic treatment, all patients were asked to record their postoperative pain levels at the 6th, 24th, 48th, 72nd hours, and 1 week later. The data were analyzed using Chi-Squared, Independent Samples T, Cochran Q and Friedman tests. Results Statistically significant difference was not found between the distributions of pain levels at different times according to the groups (p>0.050). A statistically significant difference was observed between the distributions of pain levels measured at different times in the solution group (p<0.001). A statistically significant difference was found between the distributions of pain levels measured at different times in the gel group (p<0.001). In both groups, highest postoperative pain levels occurred in the first 6 hours. Pain levels of the gel group as 38,5% mild, 17.3% moderate, 5.8% severe and pain levels of the solution group were obtained as 46.2% mild, 26.9% moderate, 9.6% severe at the 6th hour. Conclusions The use of the gel form of NaOCI during the chemomechanical preparation of the root canals showed similar postoperative pain when compared to the solution form.
Collapse
Affiliation(s)
- Esin Ozlek
- The University of Van Yuzuncu Yıl, Faculty of Dentistry, Department of Endodontics, Van, Turkey
| | - Hüseyin Gunduz
- The University of Van Yuzuncu Yıl, Faculty of Dentistry, Department of Endodontics, Van, Turkey
| | - Gizem Kadi
- The University of Van Yuzuncu Yıl, Faculty of Dentistry, Department of Endodontics, Van, Turkey
| | - Ahmet Taşan
- The University of Van Yuzuncu Yıl, Faculty of Dentistry, Department of Endodontics, Van, Turkey
| | - Elif Akkol
- Medicadent Oral and Dental Health Clinic, Istanbul, Turkey
| |
Collapse
|
21
|
Çanakçi BC, Er Ö, Genç Şen Ö, Süt N. The effect of two rotary and two reciprocating NiTi systems on postoperative pain after root canal retreatment on single-rooted incisor teeth: A randomized controlled trial. Int Endod J 2021; 54:2016-2024. [PMID: 34383324 DOI: 10.1111/iej.13609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 01/07/2023]
Abstract
AIM This randomized clinical trial aimed to assess the effect of two rotary (ProTaper Retreatment + ProTaper Gold and Hyflex EDM) and two reciprocating (Reciproc Blue and WaveOne Gold) NiTi systems on postoperative pain after root canal retreatment on single-rooted incisor teeth. METHODOLOGY One hundred and eighty patients scheduled for root canal retreatment were randomly assigned to one of the four groups according to the NiTi system (ProTaper Retreatment + ProTaper Gold, Hyflex EDM, Reciproc Blue or WaveOne Gold) used for the removal of root canal fillings and further canal preparation. The working length was determined to be 1 mm shorter than the '0.0' mark of the apex locator. Root canals were filled with gutta-percha and an epoxy resin-based root canal sealer using a lateral compaction technique. The teeth were restored using a resin composite material. A single operator performed the retreatments in a single visit. The incidence and intensity of postoperative pain were rated on a numeric rating scale by patients 24, 48 and 72 h after retreatment. The number of analgesic tablets (400 mg Ibuprofen) taken by patients was also recorded. Data were analysed using the Mann-Whitney U, Wilcoxon and chi-square tests. RESULTS For the intensity of postoperative pain, the difference between the four groups was not significantly different (p > .05). No significant difference was found between the groups in terms of analgesic medication intake (p > .05). CONCLUSIONS The rotary and reciprocating NiTi systems tested in this study were associated with similar intensity of postoperative pain and intake of analgesics following root canal retreatment on single-rooted incisor teeth completed in one visit.
Collapse
Affiliation(s)
- Burhan Can Çanakçi
- Department of Endodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Özgür Er
- Department of Endodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Özgür Genç Şen
- Department of Endodontics, Faculty of Dentistry, Yüzüncü Yıl University, Van, Turkey
| | - Necdet Süt
- Department of Biostatistics, Medical Faculty, Trakya University, Edirne, Turkey
| |
Collapse
|
22
|
Kandemir Demirci G, Miçooğulları Kurt S, Serefoglu B, Kaval ME, Çalışkan MK. The influence of different NiTi instrumentation techniques on postoperative pain after single-visit root canal treatment. AUST ENDOD J 2021; 47:559-568. [PMID: 34278665 DOI: 10.1111/aej.12547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/27/2021] [Accepted: 07/04/2021] [Indexed: 11/30/2022]
Abstract
This study aimed to evaluate the effect of multi-file rotary (Protaper Universal) and reciprocating single-file (Reciproc Blue) root canal preparation techniques on the occurrence of postoperative pain in asymptomatic mandibular molar teeth with large periapical lesions in single-visit root canal treatment (RCT). A hundred and twenty teeth were randomly assigned to two groups: Protaper Universal (PTU) or Reciproc Blue (RB) instruments. Postoperative pain at 6, 12, 24, 48, 72 h and 7 days after obturation was measured. Mann-Whitney U-test was performed to compare the pain scores between the groups and to assess the relation of pain with patients' age and gender. Spearman's rank correlation was utilized to correlate the pain intensity and analgesic intake at different time points. There was no significant difference between the instrumentation techniques regarding postoperative pain at any time points evaluated (P > 0.05). There was a correlation between analgesic intake and intensity of pain (P < 0.05). No statistically significant difference was found among the groups assessed in the study in terms of analgesic intake (P > 0.05).
Collapse
Affiliation(s)
| | | | - Burcu Serefoglu
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Mehmet E Kaval
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Mehmet K Çalışkan
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| |
Collapse
|
23
|
de Freitas Portela FSM, De Martin AS, Pelegrine RA, Gutmann JL, Kato AS, Bueno CEDS. Effect of Foraminal Enlargement on Postoperative Pain in Necrotic Single-Rooted Teeth: A Randomized Clinical Trial. J Endod 2021; 47:1046-1051. [DOI: 10.1016/j.joen.2021.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
|
24
|
Drumond JPS, Maeda W, Nascimento WM, Campos DDL, Prado MC, de-Jesus-Soares A, Frozoni M. Comparison of Postobturation Pain Experience after Apical Extrusion of Calcium Silicate– and Resin–Based Root Canal Sealers. J Endod 2021; 47:1278-1284. [DOI: 10.1016/j.joen.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/30/2021] [Accepted: 05/21/2021] [Indexed: 12/16/2022]
|
25
|
Effect of Rotary and Reciprocating Instrumentation Motions on Postoperative Pain Incidence in Non-Surgical Endodontic Treatments: A Systematic Review and Meta-Analysis. Eur Endod J 2021; 6:3-14. [PMID: 33609019 PMCID: PMC8056811 DOI: 10.14744/eej.2020.51523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE A systematic review and meta-analysis were conducted to determine whether there are postoperative pain differences resulting from rotary and reciprocation engine-driven instrumentation motions in non-surgical endodontic treatment or retreatment at 12, 24, and 48 hours. METHODS Four electronic databases (PubMed, Embase, Cochrane Library, and Scopus) were searched to identify randomised controlled trials that compared the effects of rotary and reciprocating instrumentation motions on postoperative pain. Two authors independently screened the search results, extracted the data, and assessed the quality using the Cochrane risk of bias tool. Due to numerous variables across studies, the random effect inverse variance method for meta-analysis was applied. When significant heterogeneity among studies was present, the random effects multi-variable meta-regression analysis was performed to determine the source of heterogeneity. RESULTS At all time intervals, the incidence of postoperative pain was higher in the reciprocating instrumentation group, but was not statistically significant. There was no significant difference in the analgesic intake between groups. Meta-regression analysis determined study population sizes as a significant heterogeneous factor, while significance was not observed for preoperative pain or the pulpal diagnosis. CONCLUSION There was no difference in postoperative pain at 12, 24, and 48 hours after non-surgical root canal treatment and retreatment, using reciprocating or rotary instrumentation motions.
Collapse
|
26
|
Yu YH, Kushnir L, Kohli M, Karabucak B. Comparing the incidence of postoperative pain after root canal filling with warm vertical obturation with resin-based sealer and sealer-based obturation with calcium silicate-based sealer: a prospective clinical trial. Clin Oral Investig 2021; 25:5033-5042. [PMID: 33555456 DOI: 10.1007/s00784-021-03814-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/27/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This prospective clinical study compares postoperative pain after single-visit, non-surgical root canal treatment of teeth with irreversible pulpitis using two different root canal filling techniques. MATERIAL AND METHODS All cases were treated by endodontic residents with a standardized protocol (minimum apical size 35) and filled with one of the two techniques: warm vertical compaction technique (WVT) with gutta percha and epoxy resin-based sealer (AH Plus Jet Root Canal Sealer, Dentsply Maillefer, York, PA, USA) or sealer-based filling technique (SBT) with single cone gutta percha and calcium silicate-based sealer (EndoSequence BC Sealer, Brasseler, Savannah, GA, USA). Surveys were given to participating patients to record pain intensity on a numeric rating scale (NRS, 0-10) at 4, 24, and 48 h postoperatively. Statistical significance was set at 0.05 level. RESULTS One hundred ninety-four surveys were distributed over eighteen months. Ninety-two patients returned the survey (41 WVT and 51 SBT), of which 38% were asymptomatic irreversible pulpitis cases. The NRS values reduced over time for both techniques. No statistical difference was found between the two groups at the three time points assessed (p > 0.05). Postoperative pain was related to age, gender, presence of preoperative pain, and sealer extrusion (p < 0.05), however not related to preoperative periapical symptoms (percussion/palpation), dental arch, root type, and experience of the provider (p > 0.05). CONCLUSIONS The intensity of postoperative pain for the two obturation techniques was equivalent at evaluated time points. CLINICAL RELEVANCE The obturation technique does not influence postoperative pain. After endodontic treatment of symptomatic irreversible pulpitis teeth, the pain subsides in 48 h regardless of the technique. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT04462731.
Collapse
Affiliation(s)
- Ya-Hsin Yu
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA, 19104, USA.
| | - Larisa Kushnir
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA, 19104, USA
| | - Meetu Kohli
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA, 19104, USA
| | - Bekir Karabucak
- Department of Endodontics, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA, 19104, USA
| |
Collapse
|
27
|
Postoperative pain in endodontic retreatment of one visit versus multiple visits: a systematic review and meta-analysis of randomized controlled trials. Clin Oral Investig 2021; 25:455-468. [PMID: 33399930 DOI: 10.1007/s00784-020-03767-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The aim of this systematic review and meta-analysis (SRM) was to assess the postoperative pain (PP) after non-surgical endodontic retreatment (NSER) in a one visit compared to multiple visits. The PICO question used was "Does NSER in patients with unsatisfactory endodontic treatment in a one-visit visit have a similar PP to that of NSER in multiple visits?" MATERIALS AND METHODS This systematic review followed PRISMA and was registered in PROSPERO (CRD42019136700). Searches were performed in the PubMed/MEDLINE, Scopus, and the Cochrane Library databases for articles published until September 2020. The eligible criteria were randomized clinical trials (RCTs). The meta-analysis was based on the Mantel-Haenszel. The PP after the retreatment was analyzed using a dichotomous outcome, measured according to risk ratio (RR) when p < 0.05. The Cochrane scale was used to assess risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. RESULTS Four studies were included. In general analysis without considering intensity, one-visit NSER presented lower PP than the multiple visits only for 1 and 30 days [(RR = 0.67; CI: 0.48 to 0.93; p = 0.02), and (RR = 0.09; CI: 0.01 to 0.66; p = 0.02)], respectively. Regarding sub-analysis considering the intensity, one visit present lower mild PP when compared with multiple visits [(RR = 0.54; CI: 0.30, 0.96; p = 0.04); (RR = 0.33; CI: 0.12, 0.88; p = 0.03); and (RR = 0.12; CI: 0.02, 0.86; p = 0.03)], respectively. However, sub-analysis for moderate and severe PP showed no significant difference, independently of period evaluated (p > 0.05). Regarding the risk of bias analysis, a low risk was observed for most domains, except allocation that was considered unclear, while the certainty of evidence for each analysis was considered low. CONCLUSION Within the limitations of study, the one and multiple visit can be considered adequate, because both present a similar occurrence of PP, except for mild pain. However, due to the low number of studies, further well conducted and standardized RCTs are needed to reassess these results. CLINICAL RELEVANCE Both therapies of endodontic retreatment can be considered in clinical practice. Therefore, the endodontist must consider the patient's individual characteristics and experience to consider the best treatment approach.
Collapse
|
28
|
L.S P, Rao LN, Shetty A, Hegde MN, Shetty C. Impact on Quality of Life of Patients Treated by Different File Systems for Root Canal Treatment. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2021. [DOI: 10.1055/s-0040-1722108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Abstract
Introduction The outcomes of oral health conditions and therapy for those conditions are described by the term “oral health-related quality of life.” Oral health-related quality of life is recognized by the World Health Organization as an important part of the Global Oral Health Program. The study aims to compare the impact of three root canal preparation systems on patients’ quality of life and correlate postoperative pain with the impact on the quality of life.
Materials and Methods A survey was performed in which 90 patients were randomly assigned to three groups based on the root canal preparation system: (1) ProTaper Gold (Dentsply, Tulsa Dental Specialties, Tulsa, Oklahoma, United States), (2) Neoendo flex (Neoendo, India), and (3) Hyflex EDM/CM (Coltene Whaledent) that included 30 participants in each group. Data collection included the implementation of a demographic data questionnaire, Oral Health Impact Profile 14 (quality of life), and visual analogue scale(pain). The questionnaire was given after root canal treatment in the first 24 hours. The data obtained were statistically analyzed.
Results No significant differences were found in the quality of life among study groups. Group 1 demonstrated a highly significant difference in the postoperative pain with p value of 2.67.
Conclusion Within the limitations of the present study, Protaper Gold showed a highly significant difference in postoperative pain when compared with other file systems. No significant differences were found in the quality of life among the study groups.
Collapse
Affiliation(s)
- Priyanka L.S
- Department of Conservative Dentistry and Endodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Lakshmi Nidhi Rao
- Department of Conservative Dentistry and Endodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Aditya Shetty
- Department of Conservative Dentistry and Endodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Mithra N. Hegde
- Department of Conservative Dentistry and Endodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Chitharanjan Shetty
- Department of Conservative Dentistry and Endodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| |
Collapse
|
29
|
Jeevanandan G, Govindaraju L, Subramanian EMG, Priyadarshini P. Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial. Int J Clin Pediatr Dent 2021; 14:88-96. [PMID: 34326591 PMCID: PMC8311770 DOI: 10.5005/jp-journals-10005-1895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background One of the cardinal points to be considered during endodontic procedures in children is the measure of postoperative pain. Aim and objective To evaluate the quality of obturation and its effect on postoperative pain with three file systems in primary mandibular molars during 1 week follow-up. Materials and methods The study was conducted as a double-blinded randomized controlled trial. The participants between 6 years and 9 years old requiring a pulpectomy were recruited for the trial. Forty-five primary mandibular molars were randomly allocated into 15 teeth each in Hand K-files; Kedo-SH and Kedo-SG Blue groups. Wong Baker's FACES Pain Rating Scale was used for assessing the postoperative pain in the children for 1 week. Pearson's Chi-square test, Kruskal-Wallis test, and Mann-Whitney U test were used for analyzing the data statistically. Results Optimal fillings were observed more in the Kedo-SG Blue group (80.0%) compared to the other two groups (p < 0.017). On intergroup analysis, the Kedo-SG Blue group reported less postoperative pain compared to Kedo-SH group on day 1 while on day 7 no postoperative pain was experienced in either of the groups. Less postoperative pain was reported by the children in whom the canals were optimally filled compared to overfilling and underfilling. Conclusion Kedo-SG Blue resulted in less postoperative pain when compared to Kedo-SH and hand K-files, whereas optimally filled children experienced less postoperative pain compared to overfilling and underfilling. Clinical significance A felicitous pediatric dental practice includes appropriate assessment and management of postoperative pain in children. Hence, the present study is important in highlighting the affiliation of postoperative pain with quality of obturation following an endodontic intervention in children. How to cite this article Jeevanandan G, Govindaraju L, Subramanian EMG, et al. Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial. Int J Clin Pediatr Dent 2021;14(1):88-96.
Collapse
Affiliation(s)
- Ganesh Jeevanandan
- Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Lavanya Govindaraju
- Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Erulappan Muthu Ganapathi Subramanian
- Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Pragyna Priyadarshini
- Department of Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| |
Collapse
|
30
|
Vianna ECB, Herkrath FJ, Martins IEB, Lopes LPB, Marques AAF, Sponchiado Júnior EC. Effect of Occlusal Adjustment on Postoperative Pain after Root Canal Treatment: A Randomized Clinical Trial. Braz Dent J 2020; 31:353-359. [PMID: 32901709 DOI: 10.1590/0103-6440202003248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/18/2020] [Indexed: 01/29/2023] Open
Abstract
The aim of this prospective, randomized, clinical study was to analyze the influence of occlusal adjustment on the prevalence of postoperative pain after endodontic treatment. Seventy-eight patients, diagnosed with symptomatic irreversible pulpitis with indication for endodontic treatment, were selected to participate in the study. The participants were randomized and divided into two groups: in the occlusal adjustment group (OAG), endodontic treatment was performed with subsequent occlusal adjustment. In the control group (CG), endodontic treatment was performed without occlusal adjustment. Treatments were performed by the same operator. Pain occurrence and intensity were recorded on two scales: the verbal rating scale (VRS) and numerical rating scale (NRS). Pain assessment was carried out by a second examiner, blinded to the experiment, 6, 24 and 72 h after endodontic treatment. Data were analyzed using Mann-Whitney, chi-squared, and Fisher's exact tests. In the occlusal adjustment group, 71.1% reported postoperative pain and 67.5% reported pain in the control group. At the 6-hour assessment, 21 individuals reported pain in the occlusal adjustment group and 24 in the control group (p=0.672). At the 24-hour assessment, 18 and 19 individuals reported pain (p=0.991) and at the 72-hour assessment, 8 and 4 reported pain (p=0.219), respectively. Occlusal adjustment did not influence the prevalence of postoperative pain of endodontically treated teeth with symptomatic irreversible pulpitis.
Collapse
|
31
|
Ferreira NDS, Gollo EKF, Boscato N, Arias A, Silva EJNLD. Postoperative pain after root canal filling with different endodontic sealers: a randomized clinical trial. Braz Oral Res 2020; 34:e069. [PMID: 32696911 DOI: 10.1590/1807-3107bor-2020.vol34.0069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/20/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of this randomized clinical trial was to compare the occurrence and intensity of postoperative pain and analgesic intake after root canal treatment, using different root canal sealers. Sixty single-rooted teeth diagnosed with asymptomatic necrosis and apical periodontitis were randomly assigned to 3 experimental groups (n=20), according to the root canal sealer: AH Plus, Endofill or MTA Fillapex. Endodontic treatment was performed in two sessions, and calcium hydroxide was used as the intracanal dressing. Patients were instructed to record pain intensity as none, slight, moderate and severe. Scores from 1 to 4 were attributed to each level of pain after 24 h, 48 h and 7 days. The need for analgesic intake was also recorded. Differences in the incidence of postoperative pain and the need for an analgesic were analyzed using the chi-square test. Differences in pain intensity after treatment were analyzed using the ordinal (linear) chi-square test. No significant differences were detected among the groups in terms of either incidence or intensity of postoperative pain, or need for analgesic intake, at any timepoint (p>0.05). No pain was reported after 7 days. AH Plus, Endofill and MTA Fillapex used for filling root canals resulted in the same rate of postoperative pain and need for analgesic medication.
Collapse
Affiliation(s)
- Nadia de Souza Ferreira
- Department of Semiology and Clinics, School of Dentistry, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Noeli Boscato
- Department of Restorative Dentsitry, School of Dentistry, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Ana Arias
- Conservative Dentistry Department, School of Dentistry, Universidad Complutense de Madrid, Madrid, Spain
| | | |
Collapse
|
32
|
Fonseca B, Coelho MS, Bueno CEDS, Fontana CE, Martin ASD, Rocha DGP. Assessment of Extrusion and Postoperative Pain of a Bioceramic and Resin-Based Root Canal Sealer. Eur J Dent 2019; 13:343-348. [PMID: 31794999 PMCID: PMC6890479 DOI: 10.1055/s-0039-3399457] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objectives
The objective of this study was to compare a bioceramic and a resin-based endodontic sealer with regard to extrusion and postoperative pain.
Materials and Methods
Sixty-four patients requiring endodontic treatment of single-rooted maxillary teeth with necrotic pulps were included in this study. The root canal treatments were performed in a single visit using a size 40.06 single-file reciprocating system under 2.5% NaOCl irrigation. After irrigation with 17% ethylenediaminetetraacetic acid (EDTA) and 2.5% NaOCl, the canals were dried and randomly divided into two different groups (
n
= 32) depending on the sealer used: resin-based group (RG) in which the canals were filled with the AH Plus, and the bioceramic group (BG) in which the canals were filled with the Sealer Plus BC. Ibuprofen (600 mg) was prescribed every 6 hours if the volunteers experienced pain. The patients registered their pain sensation in a visual analog scale (VAS) card, ranging from 0 to 10 at 24-hour, 48-hour, 72-hour, and 1-week intervals.
Statistical analysis
For statistical analysis, the level of significance was set at
p
< 0.05.
Results
Sealer extrusion occurred in nine patients of the RG and in 19 patients of the BG (
p
< 0.05). The average pain level at 24-hour and 48-hour intervals was, respectively, 1.46 ± 1.96 and 0.44 ± 0.86 for RG, and 1.21 ± 2.09 and 0.09 ± 0.38 for BG. There was no report of pain after 48 hours. The mean number of tablets taken for pain relief was 0.03 ± 0.17 for RG and 0.06 ± 0.24 for BG. No statistically significant difference was found with regard to pain level and intake of pain killer tablets (
p
> 0.05).
Conclusions
The BG sealer presented significantly more extrusion than the RG sealer. Sealer extrusion was not associated with pain. The average pain level and the mean number of tablets taken for pain relief were similar in both groups.
Collapse
Affiliation(s)
- Braúlio Fonseca
- Faculdade de Odontologia São Leopoldo Mandic, Campinas, SP, Brazil
| | | | | | | | | | | |
Collapse
|
33
|
Incidence of postoperative pain after canal shaping by using Reciproc and Twisted File Adaptive systems: a prospective, randomized clinical trial. Clin Oral Investig 2019; 24:2445-2450. [DOI: 10.1007/s00784-019-03106-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/30/2019] [Indexed: 11/25/2022]
|
34
|
Adiguzel M, Tufenkci P, Pamukcu II. Comparison of postoperative pain intensity following the use of three different instrumentation techniques: A randomized clinical trial. J Dent Res Dent Clin Dent Prospects 2019; 13:133-140. [PMID: 31592309 PMCID: PMC6773924 DOI: 10.15171/joddd.2019.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 07/07/2019] [Indexed: 11/09/2022] Open
Abstract
Background. The aim of this study was to compare the postoperative pain intensity following the root canal preparation carried out with XP-endo Shaper (XPS; FKG Dentaire SA, La Chauxde-Fonds, Switzerland), iRace (iRC; FKG Dentaire SA) and Reciproc Blue (REC Blue; VDW, Munich, Germany) files. Methods. Mandibular molar teeth with asymtomatic necrotic pulps in 69 patients were randomly divided into three groups (n=23). The root canals were prepared using XPS, iRC or REC Blue instruments and obturated using the lateral condensation technique. The patients were asked to record their pain intensity at 24-, 48- and 72-hour and 1-week postoperative intervals on VAS. For intolerable pain after the procedure, ibuprofen (400 mg) was prescribed. Data were analyzed using chi-squared, Friedman, Kruskal-Wallis, and Mann-Whitney U tests. Results. The postoperative pain gradually decreased during the study period in all the groups (P<0.05). No statistically significant difference was found between iRC system and the two other systems at 12-, 24- 48-hour and 1-week intervals (P>0.05). When compared to XPS system, a higher level of postoperative pain was observed with REC Blue system at 24- and 48-hour intervals (P<0.05). Conclusion. The XPS group exhibited less postoperative pain than the REC Blue group at 24- and 48-hour intervals. iRC, XPS and REC Blue systems were found to be similar in terms of postoperative pain severity.
Collapse
Affiliation(s)
- Mehmet Adiguzel
- Department of Endodontics, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| | - Pelin Tufenkci
- Department of Endodontics, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| | - Ismail Ilker Pamukcu
- Department of Endodontics, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| |
Collapse
|
35
|
Alonaizan FA, AlFawaz YF. Is phototherapy effective in the management of post-operative endodontic pain? A systematic review of randomized controlled clinical trials. Photodiagnosis Photodyn Ther 2019; 26:53-58. [DOI: 10.1016/j.pdpdt.2019.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 02/25/2019] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
|
36
|
Tufenkci P, Adıguzel M, Yılmaz K. Intraoperative Pain During Glide Path Creation with the Use of a Rotary or Reciprocating System. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.492598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
37
|
Adıgüzel M, Yılmaz K, Tüfenkçi P. Comparison of postoperative pain intensity after using reciprocating and continuous rotary glide path systems: a randomized clinical trial. Restor Dent Endod 2019; 44:e9. [PMID: 30834231 PMCID: PMC6387895 DOI: 10.5395/rde.2019.44.e9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/02/2019] [Accepted: 01/28/2019] [Indexed: 11/25/2022] Open
Abstract
Objectives The aim of this study was to compare postoperative pain intensity after root canal treatment with One G (OG) vs. R-Pilot (RP) files used for glide path preparation. Materials and Methods Ninety-three single-canaled mandibular premolar teeth with asymptomatic non-vital pulp were randomly assigned into 3 groups (n = 31): OG, RP, or without glide path (WGP). After creating the glide path, the root canals were prepared using sequential Mtwo rotary files to size 30/0.05. One endodontic specialist carried out single-visit endodontic treatment. The patients were asked to rate the severity of postoperative pain on a visual analogue scale at 24, 48, and 72 hours after the visit. They were also asked to record their intake of prescribed analgesics taken. The data were analyzed using the χ2, Friedman, Kruskal-Wallis, and Mann-Whitney U tests. Results In all 3 groups, postoperative pain decreased significantly at each time interval (p < 0.05). At 24 hours, the OG group had less postoperative pain than the WGP group (p < 0.05). However, no significant difference was found between the RP group and the others. No statistically significant difference was found among the WGP, OG, and RP groups in postoperative pain intensity at 48 or 72 hours or in analgesic tablet intake at the 3 assessed time intervals. Conclusions The OG group had less postoperative pain than the WGP group in the first 24 hours. The OG and RP systems were similar regarding postoperative pain intensity and analgesic intake.
Collapse
Affiliation(s)
- Mehmet Adıgüzel
- Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Koray Yılmaz
- Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Pelin Tüfenkçi
- Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
| |
Collapse
|
38
|
Martins CM, De Souza Batista VE, Andolfatto Souza AC, Andrada AC, Mori GG, Gomes Filho JE. Reciprocating kinematics leads to lower incidences of postoperative pain than rotary kinematics after endodontic treatment: A systematic review and meta-analysis of randomized controlled trial. J Conserv Dent 2019; 22:320-331. [PMID: 31802813 PMCID: PMC6873607 DOI: 10.4103/jcd.jcd_439_18] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Extrusion of infected debris into the periapical tissue has been cited as the major cause of postoperative pain, regardless of instrumentation technique. Aim: Comprehensively review two different kinematics of instrumentation (reciprocating and rotary) and association to the postoperative pain after endodontic treatment. Methods: Two investigators performed a systematic review with meta-analysis. MEDLINE/PubMed, Cochrane Library, and Scopus supplied relevant data from studies published until February 2018 to answer the PICO question. Primary outcome was overall postoperative pain, and the secondary outcomes were nature of the pain (mild, moderate, and severe) at 12, 24, and 48 h. Results: Ten randomized clinical trials fulfilled eligibility criteria, and five of them were submitted in the meta-analysis. Primary outcome indicated that reciprocating system results in less postoperative pain compared to rotary system (P < 0.05). As a secondary outcome, there was no statistical difference for mild, moderate, and severe pain after 12 and 24 h using reciprocating or rotary systems (P > 0.05). However, the reciprocation system showed less severe pain after 48 h (P < 0.05). Conclusion: Rotary motion had a negative impact on postoperative pain after endodontic treatment. Furthermore, after 48 h, more patients presented severe pain under rotary motion. More randomized clinical studies would be helpful.
Collapse
Affiliation(s)
- Christine Men Martins
- Department of Dentistry, Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Sao Paulo, Brazil
| | - Victor Eduardo De Souza Batista
- Department of Dentistry, Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Sao Paulo, Brazil
| | | | - Ana Cristina Andrada
- Department of Endodontics, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
| | - Graziela Garrido Mori
- Department of Dentistry, Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Sao Paulo, Brazil
| | - João Eduardo Gomes Filho
- Department of Dentistry, Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Sao Paulo, Brazil
| |
Collapse
|
39
|
Bhagwat S, Heredia A, Padhye L. An in vivo double-blind randomized controlled study comparing the postoperative pain in single sitting root canal treatment under bupivacaine versus lignocaine used as a local anesthetic agent. ENDODONTOLOGY 2019. [DOI: 10.4103/endo.endo_1_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
40
|
Keskin C, Sivas Yilmaz Ö, Inan U, Özdemir Ö. Postoperative pain after glide path preparation using manual, reciprocating and continuous rotary instruments: a randomized clinical trial. Int Endod J 2018; 52:579-587. [DOI: 10.1111/iej.13053] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/03/2018] [Indexed: 11/29/2022]
Affiliation(s)
- C. Keskin
- Department of Endodontics Faculty of Dentistry Ondokuz Mayıs University Samsun Turkey
| | - Ö. Sivas Yilmaz
- Department of Endodontics Faculty of Dentistry Ondokuz Mayıs University Samsun Turkey
| | - U. Inan
- Department of Endodontics Faculty of Dentistry Ondokuz Mayıs University Samsun Turkey
| | - Ö. Özdemir
- Miadent Oral and Dental Health Center Ankara Turkey
| |
Collapse
|
41
|
Erdem Hepsenoglu Y, Eyuboglu TF, Özcan M. Postoperative Pain Intensity after Single- versus Two-visit Nonsurgical Endodontic Retreatment: A Randomized Clinical Trial. J Endod 2018; 44:1339-1346. [DOI: 10.1016/j.joen.2018.05.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/24/2018] [Accepted: 05/27/2018] [Indexed: 11/15/2022]
|
42
|
Oliveira PS, da Costa KNB, Carvalho CN, Ferreira MC. Impact of root canal preparation performed by ProTaper Next or Reciproc on the quality of life of patients: a randomized clinical trial. Int Endod J 2018; 52:139-148. [PMID: 30040127 DOI: 10.1111/iej.12990] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 07/21/2018] [Indexed: 12/01/2022]
Abstract
AIM To compare the impact of the two different root canal preparation systems on the quality of life of patients and correlate postoperative pain with the impact on quality of life. METHODOLOGY A randomized clinical trial was conducted with 58 patients allocated into two groups based on the root canal preparation system employed: ProTaper Next (PN) or Reciproc (R). Data collection involved the administration of a questionnaire addressing demographic and clinical characteristics, the OHIP-14 (quality of life) and a visual analog scale (pain). The latter two were the outcomes of interest and were administered in the first 24 h after root canal treatment. The data were submitted to descriptive analysis, bivariate analysis, Poisson univariate and multiple regression, and Spearman's correlation test, with a 5% significance level. RESULTS A greater frequency of impact after treatment was found for the items 'uncomfortable to eat food' and 'felt self-conscious'. No significant difference between groups was found regarding the severity of impact for total OHIP-14 score or any of the domain scores. CONCLUSIONS The two root canal preparation systems exerted a similar impact on quality of life. Postoperative pain was correlated with impact on quality of life, affecting chewing function, self-consciousness and stress. Thus, it is important for dentists to provide care capable of preventing or treating the negative consequences of such therapy.
Collapse
Affiliation(s)
- P S Oliveira
- School of Dentistry, CEUMA University, São Luís, Maranhão, Brazil
| | - K N B da Costa
- School of Dentistry, CEUMA University, São Luís, Maranhão, Brazil
| | - C N Carvalho
- School of Dentistry, CEUMA University, São Luís, Maranhão, Brazil
| | - M C Ferreira
- School of Dentistry, CEUMA University, São Luís, Maranhão, Brazil
| |
Collapse
|
43
|
Anesthetic efficacy of mental/incisive nerve block compared to inferior alveolar nerve block using 4% articaine in mandibular premolars with symptomatic irreversible pulpitis: a randomized clinical trial. Clin Oral Investig 2018; 23:839-845. [DOI: 10.1007/s00784-018-2500-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 05/29/2018] [Indexed: 10/14/2022]
|
44
|
Lopes LPB, Herkrath FJ, Vianna ECB, Gualberto Júnior EC, Marques AAF, Sponchiado Júnior EC. Effect of photobiomodulation therapy on postoperative pain after endodontic treatment: a randomized, controlled, clinical study. Clin Oral Investig 2018; 23:285-292. [DOI: 10.1007/s00784-018-2435-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 04/09/2018] [Indexed: 11/29/2022]
|
45
|
Yaylali IE, Kurnaz S, Tunca YM. Maintaining Apical Patency Does Not Increase Postoperative Pain in Molars with Necrotic Pulp and Apical Periodontitis: A Randomized Controlled Trial. J Endod 2018; 44:335-340. [DOI: 10.1016/j.joen.2017.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 11/08/2017] [Accepted: 11/09/2017] [Indexed: 10/18/2022]
|
46
|
de Souza LC, Yadlapati M, Lopes HP, Silva R, Letra A, Elias CN. Physico-chemical and Biological Properties of a New Portland Cement-based Root Repair Material. Eur Endod J 2018; 3. [PMID: 32161854 PMCID: PMC7024724 DOI: 10.5152/eej.2017.17018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To propose bismuth carbonate, a radiopacifying agent, as a new endodontic root repair material that was added to Portland cement (PC) at 2 wt%, 5 wt%, 10 wt% and 15 wt%, and physicochemical and biological properties of each formulation were evaluated in comparison to MTA-Angelus. METHODS Mixed and powder samples were analysed by scanning electron microscopy (SEM) and X-ray power diffraction (XRD), and the semiquantitative constitution of the powder was determined by energy-dispersive spectrometer (EDS). Setting time was evaluated by Vicat needle and radiopacity analysed with digital X-ray. The pH of all tested materials was observed after immersion in water for 3, 24, 48, 72 and 168 h (or 7 days). Solubility and calcium release were measured after immersion in water for 24 h. A multiparametric assay XTT-NR-CVDE was used to evaluate the cytotoxicity of the materials in human periodontal ligament (HPDL) fibroblasts. HPDL fibroblasts were exposed to PC 15% and mineral trioxide aggregate (MTA), and the expression of proinflammatory cytokines (IL1A, IL6, IL8, TNF) and bone formation genes (ALP, COL1, RUNX2) was evaluated by real-time PCR. Mineralisation of HPDL fibroblasts cocultured with PC, PC 15% and MTA was evaluated with Von Kossa staining. RESULTS PC-based groups presented more irregular and larger particles than MTA. PC and MTA showed similarities as observed by XRD and EDS. Setting time of PC-based groups was increased with the addition of bismuth carbonate. All tested materials were alkaline, and pH tended to reduce over time. All cements had solubility lower than recommended, with no difference between them (P>0.05) and showed calcium release. PC 15% had similar radiopacity when compared with MTA (P>0.05). Cell viability was higher for the tested materials than the positive control (P<0.001), but there was no difference when they were compared with negative control (P>0.05). Gene expression levels were similar for all tested groups (P>0.05). Analysed cements had positive Von Kossa staining. CONCLUSION Overall, the addition of 15% of bismuth carbonate did not result in significant changes to its physicochemical and biological properties when compared with MTA, except for the setting time, and may be considered a potential substitute for MTA.
Collapse
Affiliation(s)
- Letícia Chaves de Souza
- Department of Materials Science, Military Institute of Engineering, Rio de Janeiro, RJ, Brazil
- School of Dentistry, University of Texas Health Science Center at Houston, TX, USA
| | - Mamatha Yadlapati
- School of Dentistry, University of Texas Health Science Center at Houston, TX, USA
| | - Hélio Pereira Lopes
- Department of Endodontics, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
| | - Renato Silva
- School of Dentistry, University of Texas Health Science Center at Houston, TX, USA
| | - Ariadne Letra
- School of Dentistry, University of Texas Health Science Center at Houston, TX, USA
| | - Carlos Nelson Elias
- Department of Materials Science, Military Institute of Engineering, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
47
|
Evaluation of Effect of Foraminal Enlargement of Necrotic Teeth on Postoperative Symptoms: A Systematic Review and Meta-analysis. J Endod 2017; 43:1969-1977. [DOI: 10.1016/j.joen.2017.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 07/16/2017] [Accepted: 07/18/2017] [Indexed: 11/24/2022]
|
48
|
The Effect of Root Canal Preparation Using Single Versus Multiple Endodontic Rotary Files on Post-operative Pain, a Randomised Clinical Trial. Eur Endod J 2017; 2:1-5. [PMID: 33403334 PMCID: PMC7757951 DOI: 10.14744/eej.2017.17018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 04/10/2017] [Accepted: 05/16/2017] [Indexed: 11/29/2022] Open
Abstract
Objective: The purpose of this randomised clinical trial study was to compare the incidence and intensity of post-operative pain following the use of single-file and multi-file rotary instruments with continuous rotational motion for root canal preparation in asymptomatic permanent human teeth. Methods: A total of 105 healthy consenting patients who fulfilled specific inclusion criteria and had premolar or molar teeth diagnosed with asymptomatic irreversible pulpitis without periapical pathosis requiring endodontic treatment participated in this study. The patients were randomly allocated by stratification into five groups of 21 according to the instruments and systems used for root canal preparation: (a) Neoniti A1 (#25) single file, (b) RaCe #25/.06 single file, (c) Mtwo #25/.06 single file, (d) Easy RaCe, (e) and Mtwo multifile. Endodontic treatment was carried out in a single appointment. The severity of post-operative pain was assessed by numerical rating scale scores until complete pain relief was achieved. Analgesic consumption and the incidence of pain were also evaluated. Data were analysed by one-way ANOVA and Tukey HSD tests. Results: When comparing different instruments and systems for canal preparation, the analgesic consumption, incidence and intensity of post-operative pain did not differ (p>0.05). The highest levels of post-operative pain were experienced after 6 h in all groups. Conclusion: The post-operative pain did not differ between the single and multi-file root canal preparation techniques evaluated in this study.
Collapse
|
49
|
Comparin D, Moreira EJL, Souza EM, De-Deus G, Arias A, Silva EJNL. Postoperative Pain after Endodontic Retreatment Using Rotary or Reciprocating Instruments: A Randomized Clinical Trial. J Endod 2017; 43:1084-1088. [DOI: 10.1016/j.joen.2017.02.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 10/19/2022]
|
50
|
Hou XM, Su Z, Hou BX. Post endodontic pain following single-visit root canal preparation with rotary vs reciprocating instruments: a meta-analysis of randomized clinical trials. BMC Oral Health 2017; 17:86. [PMID: 28545437 PMCID: PMC5445416 DOI: 10.1186/s12903-017-0355-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 02/23/2017] [Indexed: 11/28/2022] Open
Abstract
Background In endodontic therapy, continuous rotary instrumentation reduced debris compared to reciprocal instrumentation, which might affect the incidence of post-endodontic pain (PP). The aim of our study was to assess whether PP incidence and levels were influenced by the choice of rotary or reciprocal instruments. Methods In this meta-analysis the Pubmed and EM databases were searched for prospective clinical randomized trials published before April 20, 2016, using combinations of the keywords: root canal preparation/instrumentation/treatment/therapy; post-operative/endodontic pain; reciprocal and rotary instruments. Results Three studies were included, involving a total of 1,317 patients, 659 treated with reciprocating instruments and 658 treated with rotary instruments. PP was reported in 139 patients in the reciprocating group and 172 in the rotary group. The PP incidence odds ratio was 1.27 with 95% confidence interval (CI) (0.25, 6.52) favoring rotary instruments. The mild, moderate and severe PP levels odds ratios were 0.31 (0.11, 0.84), 2.24 (0.66, 7.59) and 11.71 (0.63, 218.15), respectively. No evidence of publication bias was found. Conclusions Rotary instrument choice in endodontic therapy is associated with a lower incidence of PP than reciprocating instruments, while reciprocating instruments are associated with less mild PP incidence.
Collapse
Affiliation(s)
- Xiao-Mei Hou
- The Second Dental Center, Peking University School and Hospital of Stomatology, Beijing, China
| | - Zheng Su
- Department of Endodontics, Capital Medical University School of Stomatology, No. 4 Tian Tan Xi Li, Dong Cheng, Beijing, 100050, China
| | - Ben-Xiang Hou
- Department of Endodontics, Capital Medical University School of Stomatology, No. 4 Tian Tan Xi Li, Dong Cheng, Beijing, 100050, China.
| |
Collapse
|