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Nathani TI, Olivieri JG, Tomás J, Elmsmari F, Abella F, Durán-Sindreu F. Post-operative pain after single-visit root canal treatment using resin-based and bioceramic sealers in teeth with apical periodontitis: A randomised controlled-trial. AUST ENDOD J 2024. [PMID: 38887839 DOI: 10.1111/aej.12864] [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: 02/12/2024] [Revised: 04/15/2024] [Accepted: 05/21/2024] [Indexed: 06/20/2024]
Abstract
The present study aimed to compare postoperative pain in teeth with symptomatic and asymptomatic apical periodontitis (AP) following a single-visit endodontic treatment using BioRoot™ RCS or AH Plus at 8 h, 24 h and 48 h postoperatively. Postgraduate students performed endodontic treatment on 101 teeth with AP, randomised into two obturation groups. A 100-mm Visual Analog Scale was used to document the intensity of pain at preoperative, 8-h, 24-h and 48-h intervals. The Kolmogorov-Smirnov test was used for normality, and the median and interquartile ranges were compared using the Mann-Whitney U test. Preoperative pain (1.90 ± 3.50) was more frequent in teeth with symptomatic AP (p < 0.05). However, no significant differences were observed in postoperative pain at the 8-h, 24-h and 48-h intervals. Pre and postoperative pain were directly associated (p < 0.05). Single-visit root canal treatment in teeth with AP using both sealers resulted in similar levels of postoperative pain.
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Affiliation(s)
- Tousif Iqbal Nathani
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Jordi Tomás
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Firas Elmsmari
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates. Center of Medical and bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Francesc Abella
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates. Center of Medical and bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
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Zaneva-Hristova D, Borisova-Papancheva T. Incidence of Postoperative Flare-Up After Single-Visit and Multi-visit Endodontic Therapy. Cureus 2024; 16:e57995. [PMID: 38738161 PMCID: PMC11088455 DOI: 10.7759/cureus.57995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 05/14/2024] Open
Abstract
This article presents results obtained from a survey, including patients who underwent endodontic treatment by the single-visit or multi-visit method, after confirmation of the diagnosis of chronic apical periodontitis. OBJECTIVE The aim of the survey was to obtain data from the studied patients on the frequency and the type of postoperative pain after treatment of chronic apical periodontitis, as well as whether there is a relation between gender, age, and postoperative pain. MATERIALS AND METHODS A visual analog scale was used to study the intensity of postoperative pain in the treatment of teeth diagnosed with CPP, which are treated by one of two methods - single-visit or multi-visit method. The total number of surveyed patients is 71. The patients were examined and treated at the Dental Clinic "Imperial" in Varna, Bulgaria, in 2020. Thirty-one of them were treated by the single-visit method, and the remaining 40 by the multi-visit method with placement of a temporary dressing or sterile swab. RESULTS A relatively large proportion (70%) of patients reported mild pain immediately after the root canal filling. A relatively large proportion (90.3%) of patients did not report pain one week after the root canal filling. The more frequent symptoms were observed in cases treated by the multi-visit method, after the application of a temporary dressing. Patients who reported taking analgesics were treated in the multi-visit method. More frequent pain symptoms with both methods of treatment were observed in men aged 36-60 years. CONCLUSION Although exacerbation has been shown to have no significant effect on the outcome of endodontic treatment, it is highly undesirable. In the short term, the postoperative pain in patients treated by the multi-visit method through the use of intracanal medication is more pronounced. Patients receiving the single-visit treatment reported less postoperative pain.
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Affiliation(s)
- Denitsa Zaneva-Hristova
- Department of Conservative Dentistry and Endodontics, The Faculty of Dental Medicine-Varna, Varna, BGR
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Kathiria NV, Attur K, Bagda KM, Venkataraghavan KP, Patel K, Mustafa MB, Attur SK. Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial. J Contemp Dent Pract 2024; 25:180-185. [PMID: 38514417 DOI: 10.5005/jp-journals-10024-3572] [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] [Indexed: 03/23/2024]
Abstract
AIM To evaluate the intensity of postendodontic pain (PEP) using final irrigation with side-vented needle (SV), EndoActivator (EA), and Ultra X (UX) in single-visit endodontics (SVE) with F-One rotary files. MATERIALS AND METHODS A total 150 patients indicated for endodontic treatment were selected. Single-visit endodontics treatment was performed under local anesthesia. For the final irrigation protocol, they were divided into three groups: group I (SV), group II (EA), and group III (UX). The severity of PEP was assessed using visual analogue scale (VAS) score after 6, 12, 24, and 48 hours. Analgesics taken by patients, for pain, were also recorded. Finally, the data were tabulated and statistically analyzed using SPSS 20.0 software at a level of significance being 0.05. RESULTS Postendodontic pain was less in group III (UX) and group II (EA) compared with group I (SV) at 6 and 12 hours, which is statistically significant (p < 0.05). There was no statistically significant difference found after 24 hours and 48 hours. CONCLUSION The intensity of PEP was minimum in patients treated with EndoActivator and ultrasonic along with single rotary file systems. The incidence of analgesic intake was similar in all three groups. How to cite this article: Kathiria NV, Attur K, Bagda KM, et al. Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial. J Contemp Dent Pract 2024;25(2):180-185.
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Affiliation(s)
- Nishtha V Kathiria
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Visnagar, Gujarat, India, Phone: +91 9712994610, e-mail:
| | - Kailash Attur
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Visnagar, Gujarat, India
| | - Kamal M Bagda
- Department of Conservative Dentistry and Endodontics, Goenka Research Institute of Dental Science, Gandhinagar, Gujarat, India
| | | | - Kiran Patel
- Oral and Maxillofacial Surgery, Shreyas Dental Clinic, Ahmedabad, Gujarat, India
| | - Mohammed B Mustafa
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Visnagar, Gujarat, India
| | - Shylaja K Attur
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Visnagar, Gujarat, India
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Abdel-Baset ST, Fahmy SH, Obeid MF. Can instrumentation kinematics affect postoperative pain and substance P levels? A randomized controlled trial. BMC Oral Health 2024; 24:102. [PMID: 38233887 PMCID: PMC10792914 DOI: 10.1186/s12903-024-03882-x] [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: 11/15/2023] [Accepted: 01/10/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND This study aimed to assess the influence of continuous rotation and reciprocation kinematics on postoperative pain (POP) levels and substance P (SP) levels in patients diagnosed with irreversible pulpitis and symptomatic apical periodontitis (SAP). MATERIALS AND SUBJECTS A total of twenty patients were randomly assigned into two groups: Continuous Rotation Group (CRG) (n = 10), subjected to mechanical preparation with the EdgeEndox7 rotary system (Albuquerque, NM, USA), and Reciprocation Group (RG) (n = 10), treated with the EdgeOne Fire reciprocating system (Albuquerque, NM, USA). Apical fluid (AF) samples were collected, and SP levels were quantified through radioimmunoassay. POP was assessed using the Numerical Rating Scale (NRS) at various time intervals (preoperatively, 6 h, 12 h, 24 h, 48 h, and 72 h). Data were statistically analyzed utilizing the independent t-test, Mann-Whitney U test, Friedman's test, and Nemenyi post hoc test. RESULTS There was a significant increase in SP levels in the reciprocating group compared to the continuous rotation group (P ≤ 0.05). Additionally, patients in the reciprocating group reported significantly higher POP levels (P ≤ 0.05) at all measured intervals (6 h, 12 h, 24 h, and 48 h), with both groups exhibiting similar pain level reductions at the 72-hour mark. CONCLUSION Our findings suggest that continuous rotation kinematics in root canal preparation leads to a considerable reduction in SP expression and POP. TRIAL REGISTRATION The study protocol was retrospectively registered on the www. CLINICALTRIALS gov database (NCT06081335) at (13/10/2023) after the approval of the Ethics Committee, Faculty of Dentistry, Ain Shams University (FDASU-RecIM012135).
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Affiliation(s)
| | - Sarah Hossam Fahmy
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Maram Farouk Obeid
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
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Falatah AM, Almalki RS, Al-Qahtani AS, Aljumaah BO, Almihdar WK, Almutairi AS. Comprehensive Strategies in Endodontic Pain Management: An Integrative Narrative Review. Cureus 2023; 15:e50371. [PMID: 38213339 PMCID: PMC10782221 DOI: 10.7759/cureus.50371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/13/2024] Open
Abstract
This narrative review comprehensively examines the current and emerging strategies for pain management in endodontics, encompassing a wide range of pharmacological and non-pharmacological approaches. Through an extensive exploration of 20 distinct parts, the review discusses traditional analgesics, antibiotics, the use of corticosteroids, and the role of novel treatments such as platelet-rich fibrin (PRF) and cryotherapy. The review also delves into the intricacies of clinical methods, such as trephination and occlusal reduction, and discusses the potential of advanced techniques such as GABAergic signaling, acupuncture, in silico modulation, and low-level laser therapy (LLLT) for the effective management of endodontic pain. The analysis reveals a trend toward integrative methods that combine established practices with cutting-edge research, highlighting the importance of a tailored approach in endodontic pain management. The findings underscore the significance of understanding the complex nature of dental pain and the need for multifaceted treatment strategies. The review emphasizes that while traditional pharmacological methods remain foundational, emerging therapies offer promising adjuncts or alternatives, especially in cases where conventional treatments may be inadequate or unsuitable. This review aims to serve as a comprehensive resource for endodontic practitioners and researchers, offering insights into the multifarious aspects of pain management in endodontics. It underscores the ongoing evolution in the field and suggests directions for future research, particularly in refining and validating new pain management techniques.
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Affiliation(s)
| | - Reem S Almalki
- Dentistry, King Saud bin Abdulaziz University for Health and Sciences, Riyadh, SAU
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Bhardwaj A, Gupta RK, Ates AA, Wahjuningrum DA, Arıcan B, AlOmari T, Luke AM, Pawar AM. Comparison of Postoperative Pain After the Utilization of Different File Systems in Single Visit Endodontics. Patient Prefer Adherence 2023; 17:1025-1034. [PMID: 37090182 PMCID: PMC10115180 DOI: 10.2147/ppa.s405723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
Purpose This prospective single-blind, parallel-group, randomized clinical trial was aimed to compare the effect of three different rotary instrumentation systems ProTaper Next (PTN), Self-Adjusting File (SAF) and XP-endo Shaper (XPS) on postoperative pain and analgesic intakes. Patients and Methods A total of 159 molars diagnosed with symptomatic irreversible pulpitis were randomly divided into three study groups according to the instrumentation techniques: PTN (n = 54), SAF (n = 52), and XPS (n = 53). The preoperative pain scores were taken before the onset of treatment in the groups. After a single appointment for root canal treatment, the patients were asked to rate the level of their pain according to the Visual Analog Scale (VAS) of 100 mm at 6, 24, 48, and 72-hour post-treatment intervals. Ibuprofen was prescribed to be taken while experiencing pain; patients were requested to note the number of pills consumed at intervals after treatment. Results The patients in SAF and XPS groups had lower mean VAS scores than the PTN group at 24-, 48-, and 72-hour intervals (p < 0.05). The most common analgesic intake was optimally seen in the PTN group at a 6-hour interval. All shaping procedures caused postoperative pain, whose intensity decreased with time. Conclusion The SAF and XPS groups had a lesser intensity of pain as well as minimum analgesic intakes as compared to the PTN group. All instrumentation systems moderately caused pain, and the PTN group experienced the highest pain among others.
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Affiliation(s)
- Anuj Bhardwaj
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, India
- Department of Conservative Dentistry, Universitas Airlangga, Surabaya, Indonesia
| | - Rudra Kumar Gupta
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, India
| | - Ayfer Atav Ates
- Department of Endodontics, Istinye University, Faculty of Dentistry, Istanbul, Turkey
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Universitas Airlangga, Surabaya, Indonesia
- Correspondence: Dian Agustin Wahjuningrum, Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia, Email
| | - Burçin Arıcan
- Department of Endodontics, Bahçeşehir University, School of Dental Medicine, Istanbul, Turkey
| | - Taher AlOmari
- Department of Conservative Dentistry, Jordan University of Science and Technology, Al-Ramtha, Jordan
| | - Alexander Maniangat Luke
- Department of Clinical Science, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Alexander Maniangat Luke, Department of Clinical Science, College of Dentistry, Ajman University, J1 Building C Block, Al-Jurf 346, Ajman, United Arab Emirates, Email
| | - Ajinkya M Pawar
- Department of Conservative Dentistry, Universitas Airlangga, Surabaya, Indonesia
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, 400008, India
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Magar SS, Alfayyadh AY, Alruwaili KK, Almunahi HFF, Alsharari AHL, Magar SP. The Determination of Flare-Up Incidence and Associated Risk Factors During Endodontic Treatment: An Observational Retrospective Study. Cureus 2022; 14:e31424. [DOI: 10.7759/cureus.31424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/07/2022] [Indexed: 11/15/2022] Open
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Antony D, Subramanian A, Nivedhitha M, Solete P, Balasubramaniam A. Post-endodontic pain with different engine-driven endodontic instruments in multi-visit root canal therapy: A systematic review and meta-analysis. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_127_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Hosny NS, El Khodary SA, El Boghdadi RM, Shaker OG. Effect of Neem (Azadirachta indica) versus 2.5% sodium hypochlorite as root canal irrigants on the intensity of post-operative pain and the amount of endotoxins in mandibular molars with necrotic pulps: a randomized controlled trial. Int Endod J 2021; 54:1434-1447. [PMID: 33884661 DOI: 10.1111/iej.13532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 12/13/2022]
Abstract
AIM To assess the effect of Neem versus 2.5% NaOCl as root canal irrigants on the intensity of post-operative pain and amount of endotoxins following root canal treatment of mandibular molars with necrotic pulps. METHODOLOGY This parallel, prospective, double-blinded, randomized controlled trial with allocation ratio 1:1 was conducted in the out-patient clinic of the Endodontic Department, Faculty of Dentistry, Cairo University, Egypt. Fifty healthy patients with mandibular molars with necrotic pulps were randomly assigned into two equal groups using computer software. In the intervention group, root canals were irrigated using Neem; whilst 2.5% NaOCl was used in the control group. A standard root canal treatment was performed in two visits using ProTaper Next rotary files, with no intracanal medication. Pain intensity was assessed using a numerical rating scale (NRS) 6, 12, 24 and 48 h following instrumentation and canal filling. Endotoxin samples were collected using three paper points before and after canal instrumentation and a sandwich ELISA method was used to quantify the level of endotoxins. Demographic, baseline, and outcome data were collected and analysed using chi-square tests (for the comparisons of categorical variables), Mann-Whitney tests (for non-normally distributed variables) and Student's t tests (for normally distributed variables), A P-value < 0.05 was considered to be statistically significant. RESULTS The mean pain scores within the two groups decreased continually over time. The mean pain scores in the Neem group were lower than those in the 2.5% NaOCl group at 6, 12, 24 and 48 h following instrumentation and canal filling with no significant difference between them except at 24 h following instrumentation (P = 0.012). Both irrigants significantly reduced endotoxin levels compared to the pre-instrumentation samples (P < 0.001) by 8% for the NaOCL group and 18% for the Neem group. CONCLUSION Neem and 2.5% NaOCl were not significantly different in terms of reducing the intensity of post-operative pain during all follow-up periods except at 24 h following instrumentation where Neem was associated with lower pain intensity. Both irrigants significantly reduced endotoxin levels but were not effective in eliminating endotoxins completely from root canals of mandibular molars with necrotic pulps.
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Affiliation(s)
- N S Hosny
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - S A El Khodary
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - R M El Boghdadi
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - O G Shaker
- Department of Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
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Sun C, Sun J, Tan M, Hu B, Gao X, Song J. Pain after root canal treatment with different instruments: A systematic review and meta-analysis. Oral Dis 2018. [DOI: 10.1111/odi.12854] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C Sun
- College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences; College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education; College of Stomatology; Chongqing Medical University; Chongqing China
| | - J Sun
- College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences; College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education; College of Stomatology; Chongqing Medical University; Chongqing China
| | - M Tan
- College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences; College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education; College of Stomatology; Chongqing Medical University; Chongqing China
| | - B Hu
- College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences; College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education; College of Stomatology; Chongqing Medical University; Chongqing China
| | - X Gao
- College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences; College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education; College of Stomatology; Chongqing Medical University; Chongqing China
| | - J Song
- College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences; College of Stomatology; Chongqing Medical University; Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education; College of Stomatology; Chongqing Medical University; Chongqing China
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