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BMC Oral Health
Published in: BMC Oral Health 1/2024

Open Access 01-12-2024 | Root Canal Debridement | Research

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

Authors: Ricardo Machado, Guilherme Moreira, Daniel Comparin, Arthur Pimentel Barroso, Jaqueline Nascimento, Caio Cézar Randi Ferraz, Sérgio Aparecido Ignácio, Lucas da Fonseca Roberti Garcia, Rodrigo Rodrigues Amaral, David Shadid, Ulisses Xavier da Silva Neto

Published in: BMC Oral Health | Issue 1/2024

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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.
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Metadata
Title
Postoperative pain after single-visit root canal treatments in necrotic teeth comparing instruments’ kinematics and apical instrumentation limits – a prospective randomized multicenter clinical trial
Authors
Ricardo Machado
Guilherme Moreira
Daniel Comparin
Arthur Pimentel Barroso
Jaqueline Nascimento
Caio Cézar Randi Ferraz
Sérgio Aparecido Ignácio
Lucas da Fonseca Roberti Garcia
Rodrigo Rodrigues Amaral
David Shadid
Ulisses Xavier da Silva Neto
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2024
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-024-04225-6

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