Machado, Ricardo, Moreira, Guilherme, Comparin, Daniel, Pimentel Barroso, Arthur, Nascimento, Jaqueline, Randi Ferraz, Caio César, Aparecido Ignacio, Sergio, Roberti Garcia, Lucas da Fonseca, Rodrigues Amaral, Rodrigo, Shadid, David, and Xavier da Silva Neto, Ulisses (2024) 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, 24. 481.

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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.

Item ID:	82671
Item Type:	Article (Research - C1)
ISSN:	1472-6831
Keywords:	apical instrumentation; endodontics; root canal treatment
Copyright Information:	© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Date Deposited:	07 May 2024 23:17
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3203 Dentistry > 320304 Endodontics @ 100%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 50% 20 HEALTH > 2002 Evaluation of health and support services > 200202 Evaluation of health outcomes @ 50%
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