Postoperative Pain and Flare-Up Incidence Following Preparation with Rotary ProTaper and Single-File Reciprocating Systems: A Randomized Clinical Trial Endodontic Postoperative Pain
Journal of Dental School,
Vol. 41 No. 2 (2023),
21 January 2024
,
Page 48-54
https://doi.org/10.22037/jds.v41i2.42806
Abstract
Objectives Techniques used in root canal treatment (RCT) can cause postoperative pain. This clinical trial study aimed to compare the degree of postoperative pain following RCT using ProTaper Next rotary files and VDW reciprocating single-file systems.
Methods Initially, a pilot study involving 10 patients in each group was performed to determine the final sample size. Sixty molars with irreversible pulpitis were randomly prepared using the Reciproc or ProTaper system. Postoperative pain severity was assessed using the Visual Analog Scale (VAS), categorizing pain level as no pain, mild, moderate, or severe before and immediately after treatment, as well as at 2, 6, 12, 24, and 48 hours postoperatively. Pain scores were analyzed using the Mann-Whitney U test to compare the two groups, and the impact of various factors on predicting postoperative pain incidence was assessed using PLUM ordinal regression (P < 0.05). The non-parametric Friedman test was used to evaluate differences in means before and after treatment.
Results No significant differences were observed in pain score classifications between the Reciproc and ProTaper preparation systems before treatment, immediately after treatment, and at 2, 6, 12, 24, and 48 hours postoperatively. However, pain severity scores reported for the ProTaper system were slightly higher than those for Reciproc, with the difference becoming more noticeable 24 hours after treatment. None of the studied factors significantly predicted postoperative pain incidence.
Conclusion Within the study's limitations and despite the absence of significant differences, using the single-file Reciproc system for tooth preparation appeared to yield slightly more favorable outcomes in alleviating postoperative pain of RCTs.
- Postoperative pain
- Rotary ProTaper system
- Endodontic Treatment
- Nickel-Titanium Instruments
How to Cite
References
Sharma A, Sharma R, Sharma M, Jain S, Rai A, Gupta S. Endodontic flare-ups: an update. Cureus. 2023;15(7):e41438.
Azim AA, Azim KA, Abbott PV. Prevalence of inter-appointment endodontic flare-ups and host-related factors. Clinical oral investigations. 2017;21(3):889-94.
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 (Kaunas). Medicina (Kaunas). 2021 Dec 29;58(1):50.
Fazlyab M, Esmaeili Shahmirzadi S, Esnaashari E, Azizi A, Moshari AA. Effect of low-level laser therapy on postoperative pain after single-visit root canal retreatment of mandibular molars: a randomized controlled clinical trial. Int Endod J. 2021;54(11):2006-15.
Albuquerque PP, Hungaro Duarte MA, Pelegrine RA, Kato AS, Stringheta CP, Duque JA, et al. Influence of foraminal enlargement on the apical extrusion of filling material: volumetric analysis using micro-computed tomography. Aust Endod J. 2020;46(2):210-6.
Borges Silva EA, Guimarães LS, Küchler EC, Antunes LAA, Antunes LS. Evaluation of effect of foraminal enlargement of necrotic teeth on postoperative symptoms: a systematic review and meta-analysis. J Endod. 2017;43(12):1969-77.
Mostafa MEHAA, El-Shrief YAI, Anous WIO, Hassan MW, Salamah FTA, El Boghdadi RM, et al. Postoperative pain following endodontic irrigation using 1.3% versus 5.25% sodium hypochlorite in mandibular molars with necrotic pulps: a randomized double-blind clinical trial. Int Endod J. 2020;53(2):154-66.
Bassam S, El-Ahmar R, Salloum S, Ayoub S. Endodontic postoperative flare-up: an update. Saudi Dent J. 2021;33(7):386-94.
Mohammadi Z, Jafarzadeh H, Shalavi S, Kinoshita JI. Establishing apical patency: to be or not to be? J Contemp Dent Pract. 2017;18(4):326-9.
Eliasz W, Czarnecka B, Surdacka A. Apical extrusion of debris during root canal preparation with proTaper Next, waveOne gold and twisted files. Materials (Basel). 2021;14(21):6254..
Pereira ES, Gomes RO, Leroy AM, Singh R, Peters OA, Bahia MG, et al. Mechanical behavior of m-wire and conventional NiTi wire used to manufacture rotary endodontic instruments. Dent Mater. 2013;29(12):e318-24.
Tabassum S, Zafar K, Umer F. Nickel-titanium rotary file systems: what's new? Eur Endod J. 2019;4(3):111-7.
Vieira TM, Cardoso RM, Alves NCC, Emanuel Acioly Conrado de Menezes S, Batista SM, Silva SA, et al. Cyclic fatigue resistance of blue heat-treated instruments at different temperatures. Int J Biomater. 2021;2021:5584766.
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(8):5033-42.
Talebzadeh B, Nezafati S, Rahimi S, Shahi S, Lotfi M, Ghasemi N. Comparison of manual and rotary instrumentation on postoperative pain in teeth with asymptomatic irreversible pulpitis: a randomized clinical trial. Iran Endod J. 2016;11(4):273-9.
Bryson LM, Fernandez Rivas D, Boutsioukis C. Cleaning of used rotary nickel-titanium files in an ultrasonic bath by locally intensified acoustic cavitation. Int Endod J. 2018;51(4):457-68.
Kumar U, Parmar P, Vashisht R, Tandon N, Kaur CK. Incidence of postoperative pain after using single continuous, single reciprocating, and full sequence continuous rotary file system: a prospective randomized clinical trial. J Dent Anesth Pain Med .2023;23(2):91-9.
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. 2019;23(1):285-92.
Kim JH, Cho SY, Choi Y, Kim DH, Shin SJ, Jung IY. Clinical efficacy of sealer-based obturation using calcium silicate sealers: a randomized clinical trial. J Endod. 2022;48(2):144-51.
Mollashahi NF, Saberi EA, Havaei SR, Sabeti M. Comparison of postoperative Pain after root canal preparation with two reciprocating and rotary single-file systems: a randomized clinical trial. Iran Endod J. 2017;12(1):15-9.
Vijayran VK, Khetarpal A, Vats A, Ahlawat M, Singhal N, Harshita. Comparison of the incidence of postoperative pain in single sitting root canal treatment after using two reciprocating systems and two continuous rotary systems: an in vivo study. J Conserv Dent. 2023;26(1):12-9.
Georgopoulou M, Anastassiadis P, Sykaras S. Pain after chemomechanical preparation. Int Endod J. 1986;19(6):309-14.
Rao RD, Shivangi S, Jain AK, Verma MR, Guha A, Langade D. Comparative evaluation of postoperative pain following chemomechanical preparation of single-rooted nonvital teeth with symptomatic apical periodontitis with and without laser irradiation: a double-blind randomized placebo controlled clinical trial. J Conserv Dent. 2022;25(6):610-5.
Harrison JW, Baumgartner JC, Svec TA. Incidence of pain associated with clinical factors during and after root canal therapy. part 2. postobturation pain. J Endod. 1983;9(10):434-8.
Siqueira Jr J, Barnett F. Interappointment pain: mechanisms, diagnosis, and treatment. Endodontic Topics. 2004;7(1):93-109.
Kurnaz S. Comparison of postoperative pain after foraminal enlargement of necrotic teeth using continuous rotary system and reciprocating instrument: a randomized clinical trial. Niger J Clin Pract. 2020;23(2):212-8.
Nair M, Rahul J, Devadathan A, Mathew J. Incidence of endodontic flare-ups and its related factors: a retrospective study. J Int Soc Prev Community Dent. 2017;7(4):175-9.
Magar SS Sr, 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(11):e31424.
Neelakantan P, Sharma S. Pain after single-visit root canal treatment with two single-file systems based on different kinematics--a prospective randomized multicenter clinical study. Clin Oral Investig. 2015;19(9):2211-7.
Mollashahi NF, Saberi EA, Havaei SR, Sabeti M. Comparison of postoperative pain after root canal preparation with two reciprocating and rotary single-file systems: a randomized clinical trial. Iran Endod J. 2017;12(1):15-9.
da Silveira MT, Batista SM, Mamede Veloso SR, de Oliveira NG, de Vasconcelos Carvalho M, de Melo Monteiro GQ. Effect of reciprocating and rotary systems on postoperative pain: a systematic review and meta-analysis. Iran Endod J. 2021;16(1):1-16.
Gondim E Jr, Setzer FC, Dos Carmo CB, Kim S. Postoperative pain after the application of two different irrigation devices in a prospective randomized clinical trial. J Endod. 2010;36(8):1295-301.
- Abstract Viewed: 133 times
- PDF Downloaded: 96 times