A Comparative Study to Assess the Post Operative Pain Intensity Following Non-Surgical Root Canal Treatment and Pulp Revascularization in Mature Necrotic teeth

Abstract

Introduction: Traditionally necrotic permanent teeth are managed through the conventional procedures of root canal treatment which is known to weaken the remaining tooth structure. Regenerative Endodontic Procedures so have emerged as an alternative to the conventional technique Aim of the study: The aim of the present study was to compare the post-operative pain intensity following non-surgical root canal treatment and revascularization procedures in mature necrotic teeth. Materials and methods: Twenty-four adult participants with 30 necrotic mature maxillary anterior teeth were randomly divided into two groups according to the treatment modality; control group: non-surgical root canal treatment; Intervention group: Blood clot revascularization technique. At the first visit in the two groups, all patients recorded their pain level preoperatively using a numerical rating scale (NRS). Mechanical preparation was performed with the ProTaper Universal Ni Ti system up to #F4 file. Double antibiotic paste (DAP) was prepared and injected and the cavity was temporarily sealed. At the second visit, three weeks later, the patients were assigned according to the randomization. The degree of spontaneous postoperative pain was measured using NRS after 6, 12, 24, and 48 hours. Results: Independent t-test between both groups; showed a highly significance difference, p value<0.05 at 6, 12, and 24 hours postoperatively while in the 48 hours there was no significant difference between both groups, p value >0.05.

Evaluation of postoperative pain and healing following regenerative endodontics using platelet‐rich plasma versus conventional endodontic treatment in necrotic mature mandibular molars with chronic periapical periodontitis. A randomized clinical trial

“…Regarding the incidence and intensity of pain after the revascularization/obturation visit (after the second visit), the pain score of the revascularization group was statistically significantly lower than the endodontic treatment group after 12 h. On the contrary Tawfik et al (2019) showed that pain after revascularization was significantly higher at 6, 12 and 24 h postoperatively when compared to the conventional endodontic treatment, whilst Arslan et al (2019) showed that there was no statistically significant difference regarding the postoperative pain between the revascularization group and the endodontic group in mature necrotic single-rooted teeth.…”

The Effect Of Different Power Modes Of A Sonic Activation Device On Postoperative Pain After Single Visit Endodontic Treatment Of Acute Irreversible Pulpitis: A Randomized Clinical Trial

“…Pain levels were higher after 6 hrs as compared to 24 and 48 hrs, that would be related to the triggering of the inflammatory process peri-apically during the endodontic treatment. The polymorphonuclear leukocytes permeate the traumatized site within 6 hours, besides the outpouring of inflammatory mediators (11) .48 hours later, the proliferation stage begins with a lowering in the PMNs counts, and the macrophages penetrate the wound location (11) . Similarly, Pak and White, (12) documented a 40% pain incidence during the first 24 hours that was abruptly reduced after cleaning and shaping throughout the first two days.…”

The Effect of Final Irrigation Agitation techniques on Post-Operative Pain After Single Visit Root Canal Treatment of Symptomatic Irreversible Pulpitis (Randomized Clinical Trial)

“…This may be related to the exacerbation or induction of the inflammatory response in the periapical tissues due to endodontic treatment. The polymorphonuclear leukocytes (PMNs) begin to enter the injured site within 6 hours, followed by an increase in the release of inflammatory mediators and neuropeptides ( 44 ). The proliferative process begins after 48 hours, which is characterised by a decrease in the PMNs population, in addition to the macrophages beginning to enter the wound site ( 44 ).…”

“…The polymorphonuclear leukocytes (PMNs) begin to enter the injured site within 6 hours, followed by an increase in the release of inflammatory mediators and neuropeptides ( 44 ). The proliferative process begins after 48 hours, which is characterised by a decrease in the PMNs population, in addition to the macrophages beginning to enter the wound site ( 44 ). Furthermore, comparable findings were detected in a systematic review conducted by Pak and White (2011) ( 45 ), in which pain incidence was 40% in the first 24 hours and then sharply declined after chemo-mechanical preparation over the first two days.…”