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

Abstract

Objectives: The objective of this study was to compare the intraoperative pain levels of patients caused from using different glide path systems in creating the glide path before the root canal shaping the teeth with asymptomatic irreversible pulpitis. Materials and Methods: The study included 88 patient with asymptomatic irreversible pulpitis in mandibular molar tooth. The teeth were randomly assigned to four groups according to use of glide path files: R-pilot (RP), WaveOne Gold Glider (WOG G), One G (OG), Proglider (PG). In all the groups, the patients were asked to specify the pain level by using Visual Analogue Scale (VAS). Kruskall-Wallis and Mann-Whitney U was used to determine significant differences at p< 0.05. Results: In the present study, it was determined that the lowest intraoperative pain level was observed in PG, followed by OG, RP, and WOG G. Statistically significant differences were observed between PG and RP and between PG and WOG G groups (p<.05). Conclusion: All of the file systems used in creating the glide path in root canal treatment caused intraoperative pain. The minimum intraoperative pain was found with PG glide path file, whereas RP and WOG G caused higher level of intraoperative pain.

Analysis of a glide path creation necessity at the initial stages of endodontic treatment

“…Instrumental techniques used in the treatment and preparation of root canals for threedimensional homogeneous obturation may play a role in the development of postoperative pain, as necrotic pulp particles, contaminated dentinal sawdust and bacteria can invade the periapical region, causing an inflammatory response. All instrumentation methods are associated with the extrusion of in-canal content, and its amount varies depending on the kinematics and design of the tool used [7,8,13,22]. According to the authors, the use of the "glide path" method (mainly rotary instruments) at the initial stages of root canal preparation can reduce the amount of substances extruded behind the apex, which, in turn, reduces the response from the periapical tissues, reducing postoperative sensitivity and pain, since there is no massive release of chemical mediators of inflammation, such as neuropeptides, metabolites of arachidonic acid, cytokines, lysosomal enzymes, platelet activating factor, fibrinolytic peptides, vasoactive amines, kinins and others [1].…”

“…The design features and taper of the One G file also help remove debris more efficiently than K-files, as do the ScoutRace, R-pilot and WaveOne Gold Glide [3,13].…”

Influence of glide path kinematics during endodontic treatment on the occurrence and intensity of intraoperative and postoperative pain: a systematic review of randomized clinical trials

“…The references of the six studies were carefully assessed to identify studies retrieved through the main search strategy, but none were found. Therefore, the six studies [2,4,18,[32][33][34] were included in the qualitative analysis of the results. Figure 1 shows the search, identification, inclusion, and exclusion processes for the articles.…”

“…The analysis of the six studies resulted in a total sample of 884 patients/ teeth, whose ages ranged from 16 to 70 years. From the six studies analyzed, only three [2,4,34] mentioned the ethical criteria involved, three [2,4,34] followed the CONSORT statement, and two reported the use of informed consent forms for the research participants [4,34]. Table 3 shows a summary of the main intervention characteristics of the studies.…”

“…Table 3 shows a summary of the main intervention characteristics of the studies. Pain occurrence and intensity were evaluated after several operative steps: during the operative session, after glide path preparation [34] or after both glide path preparation and root canal instrumentation [32,33]; following the first treatment session, after glide preparation, root canal instrumentation and obturation with gutta-percha and AH Plus sealer [2,4], or after glide path preparation and the placement of a cotton pellet in the root canals and temporary filling [18].…”