Postoperative Endodontic Pain after Treatment Using XP-endo Finisher: A Randomized Clinical Trial
Iranian Endodontic Journal,
Vol. 18 No. 3 (2023),
27 June 2023
,
Page 145-151
https://doi.org/10.22037/iej.v18i3.33925
Abstract
Introduction: This randomized clinical trial aimed to determine whether the XP-endo finisher combined with or without foraminal enlargement has any significant effect on the incidence and intensity of postoperative pain in necrotic pulps. Materials and Methods: Clinical pain levels were measured after 6, 12, 24, 48, and 72 hours and at 7 postoperative days. All treatments were performed by an endodontist in a single visit. One hundred and twenty patients were included. All patients had a single tooth treated. The patients were divided into four groups: No FE (None Foraminal Enlargement) (n=30), FE (Foraminal Enlargement) (n=30), No FE+XPF (None Foraminal Enlargement+XP-endo Finisher) (n=30) and XPF+FE (XP-endo Finisher and Foraminal Enlargement) (n=30). The canals were irrigated with sodium hypochlorite, shaped using WaveOne Gold Medium file, and then filled by using a matching single cone and AH-Plus sealer. The cavity was filled using glass ionomer cement. Pain intensity was assessed using the visual analog scale. The data were analyzed with the ANOVA and Games-Howell test. The significance level was 5%. Results: The XPF+FE group experienced a higher level of pain, being classified on the visual analog scale as moderate for 48 postoperative hours and mild for 7 postoperative days (P<0.05). In the other groups, the pain was mild, only with different time intervals (P>0.05). Conclusions: Foraminal enlargement associated with XP-endo Finisher may cause moderate postoperative pain.
- Foramen Enlargement; Postoperative Pain; Pulp Necrosis; Sodium Hypochlorite; XP-endo Finisher Instrument
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References
2. Siqueira JF Jr, Rôças IN, Favieri A, Machado AG, Gahyva SM, Oliveira JC, Abad EC. Incidence of Post-operative pain after intracanal procedures based on an antimicrobial strategy. J Endod 2002;28(6):457-60.
3. Siqueira JF Jr, Barnett F. Interappointment pain: mechanisms, diagnosis, and treatment. Endod Top 2004;7(1):93-109.
4. Saini HR, Sangwan P, Sangwan A. Pain following foraminal enlargement in mandibular molars with necrosis and apical periodontitis - a randomized controlled trial. Int Endod J 2016; 49(2):1116-23.
5. Brandão PM, de Figueiredo JAP, Morgental RD, Scarparo RK, Hartmann RC, Waltrick SBG, Souza RA. Influence of foraminal enlargement on the healing of periapical lesions in rat molars. Clin Oral Invest 2018;23(4):985-1991.
6. Silva Santos AM, Portela FMS de F, Coelho MS, Fontana CE, De Martin AS. foraminal deformation after foraminal enlargement with rotary and reciprocating kinematics: a scanning electronic microscopy study. J Endod 2018;44(1):145-48.
7. Silva EJ, Menaged K, Ajuz N, Monteiro MR, Coutinho-Filho Tde S. Postoperative pain after foraminal enlargement in anterior teeth with necrosis and apical periodontitis: a prospective and randomized clinical trial. J Endod 2013;39(2):173-76.
8. Yaylali IE, Teke A, Tunca YM. The Effect of foraminal enlargement of necrotic teeth with a continuous rotary system on postoperative pain: a randomized controlled trial. J Endod 2017;43(3):359-63.
9. Machado AG, Guilherme BPS, Provenzano JC, Marceliano-Alves MF, Gonçalves LS, Siqueira JF Jr, Neves MAS. Effects of preparation with the Self-Adjusting File, TRUShape and XP-endoShaper systems, and a supplementary step with XP-endo Finisher R on filling material removal during retreatment of mandibular molar canals. Int Endod J 2019;52(5):709-715.
10. Carvalho MC, Zuolo ML, Arruda-Vasconcelos R, Marinho ACS, Louzada LM, Francisco PA, Pecorari VGA, Gomes BPFA. Effectiveness of XP-Endo Finisher in the reduction of bacterial load in oval-shaped root canals. Braz Oral Res 2019;33:e021.
11. Ali SG, Mulay S, Palekar A, Sejpal D, Joshi A, Gufran H. Prevalence of and factors affecting post-obturation pain following single visit root canal treatment in Indian population: A prospective, randomized clinical trial. Contemp Clin Dent 2012;3(4):459-63.
12. Walters SJ. Sample size and power estimation for studies with health related quality of life outcomes: a comparison of four methods using the SF-36. Health Qual Life Out 2004;2(1):26.
13. de-Figueiredo, Fabricio Eneas Diniz; Lima, Laila Fernandes; Lima, Giana Silveira; Oliveira, Ludmila Smith; Ribeiro, Maria Amália; Brito-Junior, Manoel; Correa, Marcos Brito; Sousa-Neto, Manoel; Faria e Silva, André Luis. Correction: Apical periodontitis healing and postoperative pain following endodontic treatment with a reciprocating single-file, single-cone approach: A randomized controlled pragmatic clinical trial. Plos One 2020;15(2):e0230511.
14. Fernandes LA, Santos CFS, Nuñovero MFI, Alanis LRA, Souza PHC, Carneiro E. Root canal treatment postoperative pain assesment in head and neck postirradiated patients: a controlled clinical trial. Oral Health and Dent Mgt 2020;19(1):1-4.
15. FKG Dentaire SA. The xp endo finisher file brochure. available at: www.fkg.ch/sites/ default/files/fkg_xp_endo_brochure_en_vb.pdf. Accessed May 21, 2019.
16. Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain 1986;27(1):117-26.
17. Fairbourn DR, McWalter GM, Montgomery S. The effect of four preparation techniques on the amount of apically extruded debris. J Endod 1987;13(3):102-18.
18. Yavari HR, Jafari F, Jamioo H, Hallaj-Nezhadi S, Jafari S. The effect of submucosal injection of corticosteroids on pain perception and quality of life after root canal treatment of teeth with irreversible pulpitis: a randomized clinical trial J Endod 2019;45(5):477-482.
19. Genet JM, Hart AA, Wesselink PR, Thoden van Velzen SK. Preoperative and operative factors associated with pain after the first endodontic visit. Int. Endod J 1987;20(2):53-64.
20. Turkaydin D, Demir E, Basturk, FB, Sazak Övecoglu H. Efficacy of xp-endo finisher in the removal of triple antibiotic paste from immature root canals. J Endod 2017;43(9):1528-31.
21. Grigsby D, Ordinola-Zapata R, McClanahan SB, Fok A. Postoperative pain after treatment using the gentlewave system: a randomized controlled trial. J Endod 2020;46(8):1017-1022.
22. Balaban FS, Skidmore AE, Griffin JA. Acute exacerbations following initial treatment of necrotic pulps. J Endod 1984;10(2):78-81.
23. Al-Negrish AR, Habahbeh R. Flare up rate related to root canal treatment of asymptomatic pulpally necrotic central incisor teeth in patients attending a military hospital. J Dent 2006;34(9):635-40.
24. Ng YL, Mann V, Gulabivala KA. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J 2011;44(7):583-609.
25. Ng YL, Mann V, Gulabivala KA. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J 44(7):610-625.
26. Su Y, Wang C, Ye L. Healing rate and post-obturation pain of single- versus multiple visit endodontic treatment for infected root canals: a systematic review. J Endod 2011;37(2):125-132.
27. Arias A, Azabal M, Hidalgo JJ, de la Macorra JC. Relationship between postendodontic pain, tooth diagnostic factors, and apical patency. J Endod 2009;35(2):189-92.
28. Shokraneh A, Ajami M, Farhadi N, Hosseini M, Rohani B. Postoperative endodontic pain of three different instrumentation techniques in asymptomatic necrotic mandibular molars with periapical lesion: a prospective, randomized, double-blind clinical trial. Clin Oral Invest 2016;21(1):413-418.
29. Retamozo B, Shabahang S, Johnson N, Aprecio RM, Torabinejad M. Minimum contact time and concentration of sodium hypochlorite required to eliminate enterococcus faecalis. J Endod 2010;36(3):520-523.
30. Nair PNR, Henry S, Cano V, Vera J. Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology 2005;99(2):231-252.
31. Pak JG, White SN. Pain prevalence and severity before, during, and after root canal treatment: a systematic review. J Endod 2011;37(4):429-438.
32. Menke ER, Jackson CR, Bagby MD, Tracy TS. The effectiveness of prophylactic etodolac on postendodontic pain. J Endod 2000;26(12):7120-715.
33. Gopikrishna, V, Parameswaran A. Effectiveness of prophyactic use of rofecoxib in comparison with ibuprofen on postendodontic pain. J Endod 2003;29(1):62-64.
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