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. 2023 Nov-Dec;26(6):616-620.
doi: 10.4103/JCDE.JCDE_61_23. Epub 2023 Nov 22.

Comparison of ultrasonic versus side-vented needle irrigation for reductions in bacterial growth and postoperative pain: A randomized controlled trial

Revathi Palanisamy  1 , Subha Anirudhan  1 , R Jaya Shree Roja  1 , Minu Koshy  1
Affiliations

Comparison of ultrasonic versus side-vented needle irrigation for reductions in bacterial growth and postoperative pain: A randomized controlled trial

Revathi Palanisamy et al. J Conserv Dent Endod. 2023 Nov-Dec.

Abstract

Background: Postoperative pain affects 16%-25% of root canal therapy patients. The irrigating system and irrigants used should reduce bacterial load without irrigant extrusion beyond the root canal apex, potentially reducing postoperative pain and discomfort.

Aim: This study aims to compare the effects of passive ultrasonic irrigation and side-vented needle irrigation on postoperative pain and bacterial load in single-rooted teeth with pulp necrosis.

Materials and methods: Eighty patients with pulpal necrosis in single-rooted teeth were randomly categorized into two groups (n = 40 each): Group A (side-vented needle irrigation) and Group B (passive ultrasonic irrigation). Bacterial samples were collected using sterile paper points after initial access cavity preparation (S1) and standard endodontic instrumentation + irrigation (S2). Bacterial growth was assessed on MacConkey and blood agar. Pain was recorded 30 min preoperatively and 6, 12, 24, and 48 h postoperatively.

Statistical analysis used: Chi-square test, independent t-test and paired t-test.

Results: Irrigation with Irrisafe tips showed increased number of bacteria-free samples and a significant reduction in postoperative pain (at the 6 and 12 h time-points) when compared to side-vented needle.

Conclusions: Passive ultrasonic irrigation with Irrisafe tips may be more effective than side-vented needle irrigation in reducing postoperative pain and intracanal bacterial load in patients undergoing endodontic treatment.

Keywords: Bacterial load; irrigation; passive ultrasonic activation; postoperative pain.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Representative samples with bacterial Growth on blood agar and MacConkey’s agar plates in samples from Groups A and B. (a) Group A (side-vented needle irrigation), (b) Group B (passive ultrasonic activation). Marked reductions in bacterial growth were observed in samples from Group B compared to those from Group A
Figure 2
Figure 2
(a) Bacterial growth in S2 samples obtained from Groups A and B. Group B displayed significantly (P = 0.014) decreased bacterial growth compared to Group A, (b) The Visual Analog Scale scores of patients in Group A (side-vented needle irrigation) and Group B (Irrisafe). Significant reductions in postoperative pain were observed in both groups at all the time intervals, (c) Comparison of reduction in postoperative pain between Groups A and B. *Significant differences between the two groups (P < 0.05). VAS: Visual Analog Scale
See this image and copyright information in PMC

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