Effect of three different rotary instrumentation systems on postinstrumentation pain: A randomized clinical trial

Abstract

Background:Endodontic instrumentation is liable to cause some postinstrumentation pain (PIP). Rotary endodontic instruments differ in their design, metallurgy, surface treatment, etc.Aim:This randomized clinical trial aimed to assess the incidence of PIP after root canal instrumentation with three different rotary endodontic systems which differ in their design, namely, ProTaper, Mtwo, and K3.Materials and Methods:A total of 150 patients between the ages of 25 and 50 were chosen for the study. Teeth with asymptomatic irreversible pulpitis due to carious exposure were selected. The patients received local anesthesia by inferior alveolar nerve block. After preparing the access cavity, root canal instrumentation was done with one of the three instruments (n = 50) and closed dressing was given. PIP was assessed every 12 h for 5 days, and tenderness to percussion was analyzed at the end of 1, 3, and 7 days.Statistical Analysis:Mann–Whitney U-test to determine significant differences at P < 0.01.Results:The PIP and tenderness were less in Mtwo group when compared to ProTaper and K3 groups up to 84 h and 72 h respectively and statistically significant (P < 0.05). There was no statistically significant difference between ProTaper and K3 both in PIP and tenderness.Conclusion:Rotary endodontic instrumentation causes some degree of PIP and tenderness to percussion. Among the instruments used, Mtwo causes less PIP and tenderness when compared to ProTaper and K3, and there was no difference between ProTaper and K3.Clinical Relevance:PIP is highly subjective and may vary among different subjects. The apical (3 mm) taper of ProTaper was 0.08 followed by a smaller taper, whereas, the other two files were of a constant 0.06 taper, which means there could have been a greater apical extrusion and therefore more PIP. Despite, the mean of the age was similar, there could have been a difference in the size of the canal and therefore a difference in apical extrusion and PIP.

Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial

“… 14 The prevalence of postoperative pain in children was found to be 65.6% after dental procedures whereas its prevalence after endodontic treatment in the general population varies from 3 to 58%. 15 , 16 Certain preoperative and postoperative factors are accountable for pain after endodontic treatment. Patients experiencing severe preoperative pain are found to be more prone to suffering from moderate to severe postendodontic pain when compared to those without pain before endodontic intervention.…”

Intraoperative Pain During Glide Path Creation with the Use of a Rotary or Reciprocating System

“…When compared to manual files, these systems were developed in order to simplify and accelerate the procedures of preparing the glide path. 3 Many studies 8,11,22 in the literature of endodontics examine the postoperative pain feeling of patients. Besides that, it is known that the patients, who will receive endodontic treatment, will relate the feel the fear of pain not to the period after the treatment but the pain, which they will feel during the root canal treatment.…”

“…2 The factors affecting the pain during or after the endodontic treatment are the local anesthetics, premedication, irrigation solutions and systems, root canal preparation techniques, and designs of canal instruments that were used. 3 There are many studies carried out on measuring the patients' pain level after the use of various preparation methods and different file systems in root canal treatment. 4 In general, the studies in literature focus on the post-op subjects, and there are few studies carried out on measuring the intraoperative pain level.…”

Comparison of the incidence of postoperative pain after using a continuous rotary system, a reciprocating system, and a Self-Adjusting File system in single-visit endodontics: A prospective randomized clinical trial

“…The instrument systems used in this study were based on a close match in terms of tip size of the instruments to maintain standardization and to rule out the effect of varying tip diameters on postoperative pain. [ 6 7 8 ]…”

“…Postoperative pain associated with irreversible pulpitis is commonly associated with preparation procedures, arising from an immune response to the irrigant, microorganisms present in extruded debris, overinstrumentation, or foreign body reactions to filling materials. [ 6 7 8 ]…”