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

Abstract

Objective To evaluate the degree of postoperative pain and rate of analgesic intake in patients with symptomatic irreversible pulpitis in mandibular first molar teeth at 6 h, 12 h, 24 h, 48 h, and 72 h after using different irrigation activation techniques in single-visit endodontic treatment. Methods A total of 78 patients with symptomatic irreversible pulpitis with no signs of periapical pathology were randomly divided into 3 groups according to the final irrigation activation technique; Group XP-endo Finisher, Group Ultra X ultrasonic device, and Group side-vented needle. The teeth underwent standardised single-visit root canal treatment procedures using 2.5% sodium hypochlorite for irrigation. Each patient was given a chart to record postoperative pain at 6, 12, 24, 48 and 72 hours intervals. Ibuprofen, 400 mg tablets, was prescribed to be taken when the pain was unbearable. The incidence and number of analgesic tablets taken were recorded. Data were analysed using a Kruskal-Wallis test followed by a pairwise Mann-Whitney U test with Bonferroni correction for intergroup comparisons and Freidman’s test followed by Dunn’s post hoc test for intragroup comparisons. Results No statistically significant difference was found between all groups regarding the incidence and intensity of pain at different time intervals (p>0.05). There was no significant difference in analgesic intake between different groups, with most cases in all groups not taking analgesics (p>0.05). Conclusion Adding XP-endo Finisher or passive ultrasonic irrigation to the final irrigation protocol in single-visit endodontic treatment had no significant effect on postoperative pain or analgesic intake.

The effect of the irrigant activation protocol on postoperative pain in maxillary incisors with asymptomatic apical periodontitis: A three‐arm randomized clinical trial

“…This previous study concluded that there were no statistically significant differences between the previous groups. The reason for the difference between the current study and the previous study may be due to the fact that in the current study, irrigation was activated with longer times of the three irrigants (5.25% NaOCl, 17% EDTA, and 2% CHX) that were used in the case of necrotic teeth with periapical lesions (Ali, 2022 ).…”

“…Some studies indicated that IAS may relieve PP in comparison with CI (Elzainy et al, 2022 ; Erkan et al, 2022 ). On the other hand, some studies did not find differences in PP levels between IAS and CI (Ali, 2022 ; Sobhy et al, 2022 ). Although CI could be a control group, the number of participants in the current study didn't help to increase the groups of the study.…”

“…However, in the current study, p-values for age and gender showed that the allocation of patients into various groups was randomized, which means that patient sample had similar distributions among the three groups. Therefore, the effect of these variables was ignored in accordance with previous studies (Ali, 2022;Alves, 2010). Moreover, patients with preoperative anxiety were excluded.…”