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Meta-Analysis
. 2023 Aug;27(8):4157-4171.
doi: 10.1007/s00784-023-05151-7. Epub 2023 Jul 19.

Prevalence of postoperative pain after endodontic treatment using low and high concentrations of sodium hypochlorite: a systematic review and meta-analysis

Rayssa Sabino-Silva  1 , Ihan Vitor Cardoso  1 , Filipe Colombo Vitali  1 , Ana Maria Hecke Alves  1 , Beatriz Dulcineia Mendes Souza  1 , Eduardo Antunes Bortoluzzi  2 , Lucas da Fonseca Roberti Garcia  1 , Cleonice da Silveira Teixeira  3
Affiliations
Meta-Analysis

Prevalence of postoperative pain after endodontic treatment using low and high concentrations of sodium hypochlorite: a systematic review and meta-analysis

Rayssa Sabino-Silva et al. Clin Oral Investig. 2023 Aug.

Abstract

Objectives: To determine the prevalence of postoperative pain after endodontic treatment using low (LC) and high (HC) concentrations of sodium hypochlorite (NaOCl).

Materials and methods: Six databases and the grey literature were searched to identify randomized clinical trials that evaluated postoperative pain after endodontic treatment using NaOCl. NaOCl concentrations were dichotomized into 'LC' (0.5% to 3%) and 'HC' (≥ 5%) and a proportion meta-analysis was applied to determine the postoperative pain prevalence: overall and according to pain intensity and postoperative time. The prevalence of patients using pain control medication was also determined. A significance level of 5% and a random effect model were applied for data analysis. Between-study heterogeneity was assessed by I2 index. Risk of bias (RoB) was assessed using the Cochrane Risk-of-Bias 2.0 tool. The certainty of evidence was assessed using the GRADE approach.

Results: Ten studies were included in the review and eight in the meta-analysis. The overall prevalence of postoperative pain was 45% in LC and 39% in HC. The prevalence of pain in LC and HC after 24 h was 25% and 40%, respectively. After 48 h, the prevalence decreased to 10% in LC and 25% in HC. 'Absent pain' was the most prevalent score. The prevalence of patients who used medication was 9% in LC and 15% in HC. Three studies were classified as 'high RoB', five as 'low RoB', and two as 'some concerns'. The certainty of evidence was very low.

Conclusions: The overall prevalence of postoperative pain after endodontic treatment using LC and HC of NaOCl was 45% and 39%, respectively.

Clinical relevance: Postoperative pain is common after endodontic treatment using NaOCl, but tends to decrease over time.

Keywords: Endodontics; Irrigating solution; Postoperative pain; Sodium hypochlorite; Systematic review.

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References

    1. Mostafa M, El-Shrief YAI, Anous WIO, Hassan MW, Salamah FTA, El Boghdadi RM, El-Bayoumi MAA, Seyam RM, Abd-El-Kader KG, Amin SAW (2020) Postoperative pain following endodontic irrigation using 1.3% versus 5.25% sodium hypochlorite in mandibular molars with necrotic pulps: a randomized double-blind clinical trial. Int Endod J 53:154–166. https://doi.org/10.1111/iej.13222 - DOI - PubMed
    1. Boutsioukis C, Psimma Z, van der Sluis LW (2013) Factors affecting irrigant extrusion during root canal irrigation: a systematic review. Int Endod J 46:599–618. https://doi.org/10.1111/iej.12038 - DOI - PubMed
    1. Iandolo A, Dagna A, Poggio C, Capar I, Amato A, Abdellatif D (2019) Evaluation of the actual chlorine concentration and the required time for pulp dissolution using different sodium hypochlorite irrigating solutions. J Conserv Dent 22:108–113. https://doi.org/10.4103/jcd.jcd_165_19 - DOI - PubMed - PMC
    1. Tejada S, Baca P, Ferrer-Luque CM, Ruiz-Linares M, Valderrama MJ, Arias-Moliz MT (2019) Influence of dentine debris and organic tissue on the properties of sodium hypochlorite solutions. Int Endod J 52:114–122. https://doi.org/10.1111/iej.12986 - DOI - PubMed
    1. Demenech LS, Tomazinho FSF, Baratto-Filho F, Brancher JA, Pereira LF, Gabardo MCL (2021) Biocompatibility of the 8.25% sodium hypochlorite irrigant solution in endodontics: An in vivo study. Microsc Res Tech 84:1506–1512. https://doi.org/10.1002/jemt.23706 - DOI - PubMed

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