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Evaluation of Postoperative Pain Following Single-Visit Root Canal Treatment with Rotary and Reciprocal Ni-Ti File Systems in Children.

ABSTRACT: Background and Objectives: Postoperative pain is a common symptom of a flare-up after root canal treatments (RCTs). Insufficient instrumentation, extrusion of irrigation solutions and debris, and the existence of a periapical lesion are the factors affecting postoperative pain after root canal treatments. The aim of this study was to evaluate the postoperative pain and instrumentation time of the single-file reciprocating system and multiple-file Ni-Ti rotary system in children ages 9-12 years old. Materials and Methods: Our study was conducted on 51 permanent mandibular molars with the diagnosis of irreversible pulpitis. Patients were randomly assigned into two groups, and RCTs were completed with either the Reciproc Blue or Protaper NEXT file systems. Instrumentation time for each system was noted, and patients were given a pain scale that included a visual analog scale for 6, 24, 48, and 72 h after treatment. Postoperative pain scores and instrumentation times were analyzed statistically with a chi-square test and Student's t-test. Results: There was no statistically significant difference in postoperative pain between the Reciproc Blue and Protaper NEXT systems at all time intervals. Instrumentation time was significantly shorter in the Reciproc Blue group in comparison with the Protaper NEXT group. Conclusions: Postoperative pain findings following RCT using single-file reciprocating systems were similar to the rotary system group. However, chair time in the reciprocating system group was significantly lower. This provided a comfortable and patient-friendly treatment approach for children, and could enhance their cooperation.

SUBMITTER: Atesci AA

PROVIDER: S-EPMC8780144 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThere are few studies in the literature about the effect of obturation techniques on postoperative pain. Besides, GuttaFlow2 was used for the first time in this study regarding postoperative pain. This study aimed to compare the postoperative pain levels and incidence following single-visit root canal treatment with different canal filling techniques; cold lateral compaction (CLC), thermoplasticised solid-core carrier (GuttaCore) based filling and cold free-flow compaction (GuttaFlow2) technique.MethodsThe patients (n = 93) having single-rooted teeth with a single canal diagnosed with asymptomatic irreversible pulpitis or single-rooted vital teeth with a single canal requiring endodontic treatment because of prosthetic reasons were enrolled in this study. Patients were randomized into three groups (n = 31) according to the obturation technique. A single operator performed all the treatments in a single visit. Data on obturation levels, postoperative pain and analgesic intake frequency were recorded at postoperative 6, 12 and 24 h and daily afterward until the 7th day. Postoperative pain was measured by visual analogue scale (VAS). The date were statistically analyzed with chi-squared tests (for the analyses of the categorical data), the nonparametric Kruskal-Wallis test (for the comparisons of VAS score) and with the Friedman test (for the assessments of the changes in VAS scores over time).ResultsThe GuttaCore group recorded the higher pain levels, except first 12 h, on the other hand, the GuttaFlow2 group recorded the lower pain levels at all time periods. Significant differences occurred among the groups during the first 4 days (p < 0.05), except at 12 h (p = 0.054). The patients in the CLC and GuttaFlow2 groups did not need to use the prescribed analgesic; however, one patient in the GuttaCore group used it once.ConclusionsPostoperative pain levels following root canal therapy were affected by the obturation technique especially first 4 days following obturation.

Project description:BackgroundTo investigate the complications associated with the use of nickel titanium rotary instruments (NiTi-RIs) for root canal treatments (RCTs), in Saudi Arabia dental practice, and to explore the influencing factors.MethodsAfter obtaining an ethical approval, two pilot studies were conducted to formulate the final questionnaire. The sample size was measured taking into consideration 60% expected response rates and confidence level of 99.9%. The questionnaire was emailed to 600 general dentists (GDs) randomly selected from the dental register and all of the endodontists (175). The email's introduction clarified objectives of the study and guaranteed that all of the collected information would remain confidential. A reminder was sent after 10?weeks. The data were collected and analyzed using the chi-squared test at a 0.05 significance level.ResultsWith a 51% overall response rate, 71.9% off the respondents used NiTi-RIs. The majority (83.1%) experienced complications while using NiTi-RIs; with the instruments' fracture being significantly the most common complication (52.7%) (p?<?0.001). The majority (87.7%) experienced NiTi-RIs' fracture at least once; with more endodontists (94.3%) than GDs (83.3%) (p?<?0.001). The greater the number of weekly performed RCTs and participants' experiences, the more NiTi-RIs fractures and the greater the number of fracture incidents (p?<?0.001). While 60% of those who performed 1-3 RCTs per week experienced NiTi-RIs fractures, 100% of those who performed more than 12 RCTs per week did so. The highest percentage of those who experienced more than 10 fractured NiTi-RIs (60%) was within the group who performed more than 12 RCTs per week. Although fracture incidents decreased with a smaller number of reuses, there was no significant correlation between the number of fractured instruments and NiTi-RIs discard strategy (p???0.05).ConclusionFracture incidence was the most common complication while using NiTi-RIs, regardless of the clinicians' experiences and skills. While the single use may reduce NiTi-RIs fractures, to some extent, the greater number of RCTs performed per week was the most influential factor.

Project description:Background:Dentistry has undergone an evolution in endodontics practice caused by the advancement of rotary techniques for root canal preparation and their subsequent incorporation into the teaching of dentistry undergraduates. This research aimed to evaluate the shaping ability of third-year dental students as their first experience in rotary instrumentation using ProTaper Universal (PTU) and ProTaper Next (PTN) (Dentsply Maillefer) rotary instruments in simulated curved canals. Methods:Forty students instrumented 200 simulated canals with a 40° curvature in resin blocks according to the manufacturer's instructions with PTU and 39 students and 195 canals with PTN files. The canals were prepared at a speed of 300 rpm using a 16:1 reduction hand-piece powered by an electric motor (Xsmart; Dentsply Maillefer). The final apical preparation was set to F2 for the PTU and X2 for the PTN group. The change in canal curvature was evaluated based on Schneider technique using the AutoCAD 2007 software on post-digital photographs. The incidence of instrument fracture and deformation, the incidence of ledge, the change in working length (WL), and the working time were noted. The data were analyzed with Student's t-test and Chi-Square test at a significance level of 0.05 using SPSS. Results:PTN maintained the original canal curvature better, resulting in fewer fractures and ledges, and shaped the canals faster than the PTU (P < 0.05). The mean curves of the resin canals after the instrumentation for the PTU and PTN groups were 24.03° ± 3.14° and 25.64° ± 2.72°, respectively. Thirty-three (17.4%) PTU and 18 (9.3%) PTN files fractured (p < 0.05). Nine (4.5%) PTU and 2 (2.6%) PTN deformed (p > 0.05). The change in WL after instrumentation was 0.97 mm ± 0.95 mm in PTU and 0.96 mm ± 0.80 mm in PTN (p < 0.05). The mean times were 627 s ± 18 s for PTU and 379 s ± 18 s for PTN (p < 0.000). Discussion:PTN can be recommended in severely curved root canals in terms of maintenance of the original canal curvature, superior instrument fracture and fewer ledges. Even if training before preparation provides an acceptable level of canal shaping for preclinical students, the use of NiTi rotary instruments should be included in the undergraduate dental curriculum, contributing to an increase in the quality of root canal shaping and, consequently, to an improvement of the clinical experience of students.

Project description:IntroductionRoot canal treatment is one of the oldest dental procedures for the treatment of endodontic infection. Extrusion of debris beyond the root apex during root canal instrumentation and subsequent persistence of pain are common complications. A systematic review of the evidence on reciprocating single-file instrumentation systems and their comparison with rotary single-file systems, with apical extrusion of debris as primary outcome, will be done through this study.Methods and analysisPublished ex vivo and in vitro studies with no language restriction will be included. We will search MEDLINE (Ovid), EMBASE (Ovid), Web of Science, Cochrane and Google Scholar. Strategies will be incorporated to search grey literature also. Thorough evaluation of search results, completion of data abstraction and assessment of quality will be done by two reviewers independent from each other. Assessment of included studies will be done by utilising an evidence model developed on the basis of standards of quality reported in guidelines to document ex vivo and in vitro studies regarding dental materials and pertained for extrusion of debris apically and has been already used in quality assessment of studies involving quantification of debris extrusion apically. We will calculate the standardised mean differences for apically extruded debris, with congruent 95% CIs. We will measure the statistical heterogeneity by applying the Cochrane Q test and quantify using the I2 statistic. Existence of covariates and any potential heterogeneity will be explored through prespecified subgroup and sensitivity analyses.Ethics and disseminationApproval from an ethical research committee is not required because it will be done using data that have been already published and have no concerns related to the privacy of patients. Extensive dissemination of results from this review will be done through submission to a peer-reviewed journal for publication and conferences.Prospero registration numberCRD42019151804.

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Evaluation of Postoperative Pain Following Single-Visit Root Canal Treatment with Rotary and Reciprocal Ni-Ti File Systems in Children.

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