Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 Apr 20;24(1):481.
doi: 10.1186/s12903-024-04225-6.

Postoperative pain after single-visit root canal treatments in necrotic teeth comparing instruments' kinematics and apical instrumentation limits - a prospective randomized multicenter clinical trial

Ricardo Machado  1 , Guilherme Moreira  2 , Daniel Comparin  3 , Arthur Pimentel Barroso  4 , Jaqueline Nascimento  5 , Caio Cézar Randi Ferraz  4 , Sérgio Aparecido Ignácio  6 , Lucas da Fonseca Roberti Garcia  7 , Rodrigo Rodrigues Amaral  8 , David Shadid  9 , Ulisses Xavier da Silva Neto  5
Affiliations
Randomized Controlled Trial

Postoperative pain after single-visit root canal treatments in necrotic teeth comparing instruments' kinematics and apical instrumentation limits - a prospective randomized multicenter clinical trial

Ricardo Machado et al. BMC Oral Health. .

Abstract

Objectives: This prospective randomized multicenter clinical trial (PRMCT) investigated postoperative pain after single-visit root canal treatments in teeth affected by pulp necrosis (PN), and asymptomatic apical periodontitis (AAP) (with apical radiolucent areas) or normal periradicular tissues (without apical radiolucent areas) comparing different instruments' kinematics and apical instrumentation limits.

Methods: Before chemomechanical preparation, 240 patients/teeth were randomly distributed into four groups (n = 60) according to the instruments' kinematics (rotary or reciprocating) and apical instrumentation limits (with or without intentional foraminal enlargement [IFE]). After that, specimens were submitted to the same irrigation and obturation techniques, and the patients were referred to undergo the definitive restorations. No medication was prescribed, but the patients were instructed to take either paracetamol (750 mg every 6 h for three days) or ibuprofen (600 mg every 6 h for three days) in pain cases. Postoperative pain incidence and levels were assessed at 24-, 48-, and 72 h following treatment completion according to a verbal rating scale (VRS) following a score. The Kolmogorov-Smirnov test was applied to assess the normality of the data. Mann-Whitney U, Chi-square, Friedman's ANOVA, and Friedman's multiple 2 to 2 comparison tests were employed to identify potential significant statistical differences among the variables in the study groups (P < .05).

Results: Significant statistical differences were only observed among the groups considering tooth, periradicular status, and the occurrence of overfilling (sealer extrusion) (P < 0.00). Patients with teeth instrumented through rotary kinematics and without IFE experienced lower rates of postoperative pain; however, this difference was relevant only at 24 h (P < 0.05).

Conclusions: Postoperative pain was lower after using a rotary file system (Profile 04) inserted up to the apical constriction (AC). However, this finding was just statistically meaningful at 24 h.

Trial registration: This PRMCT was approved by the Human Research Ethics Committee of the Paranaense University - UNIPAR, Francisco Beltrão, PR, Brazil (CAAE. 46,774,621.6.0000.0109) on 02/09/2021. It was registered at The Brazilian Registry of Clinical Trials - ReBEC (RBR-3r967t) on 01/06/2023, was performed according to the Principles of the Helsinki Declaration and is reported following the Consolidated Standards of Reporting Trials Statement.

Keywords: Apical instrumentation limit; Asymptomatic apical periodontitis; Instruments' kinematics; Intentional foraminal enlargement; Postoperative pain; Root canal treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flowchart
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Gulabivala K, Ng YL. Factors that affect the outcomes of root canal treatment and retreatment-A reframing of the principles. Int Endod J. 2023;56(Suppl 2):82–115. doi: 10.1111/iej.13897. - DOI - PubMed
    1. Burklein S, Arias A: Effectiveness of root canal instrumentation for the treatment of apical periodontitis: A systematic review and meta-analysis. Int Endod J 2022. - PubMed
    1. Ordinola-Zapata R, Noblett WC, Perez-Ron A, Ye Z, Vera J. Present status and future directions of intracanal medicaments. Int Endod J. 2022;55 Suppl 3(Suppl 3):613–636. doi: 10.1111/iej.13731. - DOI - PMC - PubMed
    1. Martins JNR, Marques D, Silva E, Carames J, Versiani MA. Prevalence Studies on Root Canal Anatomy Using Cone-beam Computed Tomographic Imaging: A Systematic Review. J Endod. 2019;45(4):372–386e374. doi: 10.1016/j.joen.2018.12.016. - DOI - PubMed
    1. Siqueira JF, Jr, Rocas IN. Present status and future directions: Microbiology of endodontic infections. Int Endod J. 2022;55(Suppl 3):512–530. doi: 10.1111/iej.13677. - DOI - PubMed

Publication types