Skip to main content

Advertisement

SpringerLink
Log in

Postoperative endodontic pain of three different instrumentation techniques in asymptomatic necrotic mandibular molars with periapical lesion: a prospective, randomized, double-blind clinical trial

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

The purpose of this prospective, randomized, double-blind study was to compare postoperative pain of root canal treatment in patients with asymptomatic mandibular molar teeth with necrotic pulp and periapical lesion using three different instrumentation techniques: hand, multi-file rotary (ProTaper Universal), and reciprocating single-file (Wave-One) instrumentation techniques.

Materials and methods

Ninety-six patients who fulfilled specific inclusion criteria were assigned to three groups according to the root canal instrumentation technique used: Hand (G1), ProTaper Universal (G2), and Wave-One (G3). One-visit root canal treatment was carried out, and the severity of the postoperative pain was assessed by the Heft-Parker visual analogue scale 6, 12, 18, 24, 48, and 72 h after treatment. Data were analyzed by Kruskal-Wallis, χ 2, Cochrane Q, one-way ANOVA, and Spearman’s correlation analyses (α = 0.05).

Results

The patients in group 3 reported significantly lower postoperative pain levels at 6, 12, and 18 h compared with the patients in the two other groups (P < .05). In addition, the patients in group 2 reported significantly lower postoperative pain levels at 6 and 12 h compared with the patients in group 1 (P < .05). There were no significant differences in postoperative pain between the three groups at other time intervals (P > .05). The analgesic consumption was significantly higher in group 1 (P < .05), but no difference was seen between the two other groups (P > .05).

Clinical relevance

Postoperative pain was significantly lower in patients undergoing root canal instrumentation with the Wave-One file compared with the ProTaper Universal and hand files.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kanaa MD, Whitworth JM, Meechan JG (2012) A prospective randomized trial of different supplementary local anesthetic techniques after failure of inferior alveolar nerve block in patients with irreversible pulpitis in mandibular teeth. J Endod 38:421–425

    Article  PubMed  Google Scholar 

  2. Simpson M, Drum M, Nusstein J, et al. (2011) Effect of combination of preoperative ibuprofen/acetaminophen on the success of the inferior alveolar nerve block in patients with symptomatic irreversible pulpitis. J Endod 37:593–597

    Article  PubMed  Google Scholar 

  3. Gondim E Jr, Setzer FC, dos Carmo CB, et al. (2010) Postoperative pain after the application of two different irrigation devices in a prospective randomized clinical trial. J Endod 36:1295–1301

    Article  PubMed  Google Scholar 

  4. Jalalzadeh SM, Mamavi A, Shahriari S, et al. (2010) Effect of pretreatment prednisolone on postendodontic pain: a double-blind parallel-randomized clinical trial. J Endod 36:978–981

    Article  PubMed  Google Scholar 

  5. Pak JG, White SN (2011) Pain prevalence and severity before, during, and after root canal treatment: a systematic review. J Endod 37:429–438

    Article  PubMed  Google Scholar 

  6. Su Y, Wang C, Ye L (2011) Healing rate and post-obturation pain of single-versus multiple-visit endodontic treatment for infected root canals: a systematic review. J Endod 37:125–132

    Article  PubMed  Google Scholar 

  7. Hutchison G, Halcomb T, Reader A, et al. (2011) A prospective, randomized single-blind study of the anesthetic efficacy of frequency-dependent conduction blockade of the inferior alveolar nerve. J Endod 37:938–932

    Article  PubMed  Google Scholar 

  8. Martin M, Nusstein J, Drum M, et al. (2011) Anesthetic efficacy of 1.8 mL versus 3.6 mL of 4 % articaine with 1: 100,000 epinephrine as a primary buccal infiltration of the mandibular first molar. J Endod 37:588–592

    Article  PubMed  Google Scholar 

  9. Aggarwal V, Singla M, Miglani S, et al. (2011) A prospective, randomized, single-blind comparative evaluation of anesthetic efficacy of posterior superior alveolar nerve blocks, buccal infiltrations, and buccal plus palatal infiltrations in patients with irreversible pulpitis. J Endod 37:1491–1494

    Article  PubMed  Google Scholar 

  10. Sampaio RM, Carnaval TG, Lanfredi CB, et al. (2012) Comparison of the anesthetic efficacy between bupivacaine and lidocaine in patients with irreversible pulpitis of mandibular molar. J Endod 38:594–597

    Article  PubMed  Google Scholar 

  11. Sathorn C, Parashos P, Messer H (2008) The prevalence of postoperative pain and flare-up in single-and multiple-visit endodontic treatment: a systematic review. Int Endod J 41:91–99

    PubMed  Google Scholar 

  12. Genet J, Hart A, Wesselink P, et al. (1987) Preoperative and operative factors associated with pain after the first endodontic visit. Int Endod J 20:53–64

    Article  PubMed  Google Scholar 

  13. Walton RE (2002) Interappointment flare-ups: incidence, related factors, prevention, and management. Endod Topics 3:67–76

    Article  Google Scholar 

  14. Seltzer S, Naidorf IJ (2004) Flare-ups in endodontics: I. Etiological factors. J Endod 30:476–481

    Article  PubMed  Google Scholar 

  15. Al-Omari M, Dummer P (1995) Canal blockage and debris extrusion with eight preparation techniques. J Endod 21:154–158

    Article  PubMed  Google Scholar 

  16. Beeson T, Hartwell G, Thornton J, et al. (1998) Comparison of debris extruded apically in straight canals: conventional filing versus profile. 04 Taper series 29. J Endod 24:18–22

    Article  PubMed  Google Scholar 

  17. Hinrichs RE, Walker WA, Schindler WG (1998) A comparison of amounts of apically extruded debris using handpiece-driven nickel-titanium instrument systems. J Endod 24:102–106

    Article  PubMed  Google Scholar 

  18. Reddy SA, Hicks ML (1998) Apical extrusion of debris using two hand and two rotary instrumentation techniques. J Endod 24:180–183

    Article  PubMed  Google Scholar 

  19. Ferraz C, Gomes N, Gomes B, et al. (2001) Apical extrusion of debris and irrigants using two hand and three engine-driven instrumentation techniques. Int Endod J 34:354–358

    Article  PubMed  Google Scholar 

  20. Lambrianidis T, Tosounidou E, Tzoanopoulou M (2001) The effect of maintaining apical patency on periapical extrusion. J Endod 27:696–698

    Article  PubMed  Google Scholar 

  21. Bürklein S, Schäfer E (2012) Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems. J Endod 38:850–852

    Article  PubMed  Google Scholar 

  22. Koçak S, Koçak MM, Sağlam BC, et al. (2013) Apical extrusion of debris using self-adjusting file, reciprocating single-file, and 2 rotary instrumentation systems. J Endod 39:1278–1280

    Article  PubMed  Google Scholar 

  23. Tinoco J, De-Deus G, Tinoco E, et al. (2014) Apical extrusion of bacteria when using reciprocating single-file and rotary multifile instrumentation systems. Int Endod J 47:560–566

    Article  PubMed  Google Scholar 

  24. Peters OA (2004) Current challenges and concepts in the preparation of root canal systems: a review. J Endod 30:559–567

    Article  PubMed  Google Scholar 

  25. Capar ID, Ertas H, Ok E, et al. (2014) Comparative study of different novel nickel-titanium rotary systems for root canal preparation in severely curved root canals. J Endod 40:852–856

    Article  PubMed  Google Scholar 

  26. De-Deus G, Neves A, Silva EJ, et al. (2015) Apically extruded dentin debris by reciprocating single-file and multi-file rotary system. Clin Oral Invest 19:357–361

    Article  Google Scholar 

  27. Yared G (2008) Canal preparation using only one Ni-Ti rotary instrument: preliminary observations. Int Endod J 41:339–344

    Article  PubMed  Google Scholar 

  28. Varela-Patiño P, Ibañez-Párraga A, Rivas-Mundiña B, et al. (2010) Alternating versus continuous rotation: a comparative study of the effect on instrument life. J Endod 36:157–159

    Article  PubMed  Google Scholar 

  29. Kerekes K, Tronstad L (1979) Long-term results of endodontic treatment performed with a standardized technique. J Endod 5:83–90

    Article  PubMed  Google Scholar 

  30. Harrington GW, Natkin E (1992) Midtreatment flare-ups. Dent Clin N Am 36:409–423

    PubMed  Google Scholar 

  31. Alves VO (2010) Endodontic flare-ups: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110:e68–e72

    Article  Google Scholar 

  32. Nekoofar MH, Sheykhrezae MS, Meraji N, et al. (2015) Comparison of the effect of root canal preparation by using WaveOne and ProTaper on postoperative pain: a randomized clinical trial. J Endod 41:575–578

    Article  PubMed  Google Scholar 

  33. Sathorn C, Parashos P, Messer H (2005) Effectiveness of single-versus multiple-visit endodontic treatment of teeth with apical periodontitis: a systematic review and meta-analysis. Int Endod J 38:347–355

    Article  PubMed  Google Scholar 

  34. Asgary S, Eghbal MJ (2010) The effect of pulpotomy using a calcium-enriched mixture cement versus one-visit root canal therapy on postoperative pain relief in irreversible pulpitis: a randomized clinical trial. Odontol 98:126–133

    Article  Google Scholar 

  35. Parirokh M, Yosefi MH, Nakhaee N, et al. (2012) Effect of bupivacaine on postoperative pain for inferior alveolar nerve block anesthesia after single-visit root canal treatment in teeth with irreversible pulpitis. J Endod 38:1035–1039

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endodontics, School of Dentistry, AJA University of Medical Sciences, Tehran, 8174755153, Iran

    Ali Shokraneh & Majid Ajami

  2. Department of Oral and Maxillofacial Radiology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Nastaran Farhadi

  3. Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran

    Mohsen Hosseini

  4. Department of Oral Medicine, School of Dentistry, AJA University of Medical Sciences, Tehran, Iran

    Bita Rohani

Authors
  1. Ali Shokraneh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Majid Ajami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nastaran Farhadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohsen Hosseini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bita Rohani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ali Shokraneh.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

The work was supported by the Research Deputy, AJA University of Medical Sciences, Tehran, Iran.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shokraneh, A., Ajami, M., Farhadi, N. et al. Postoperative endodontic pain of three different instrumentation techniques in asymptomatic necrotic mandibular molars with periapical lesion: a prospective, randomized, double-blind clinical trial. Clin Oral Invest 21, 413–418 (2017). https://doi.org/10.1007/s00784-016-1807-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-016-1807-2

Keywords

Search

Navigation