Comparison of postoperative pain reduction following laser, ultrasonic activation and conventional needle irrigation after root canal treatment - A randomized clinical trial.

Abstract

To compare the incidence of postoperative pain and analgesic intake on the administration of passive ultrasonic irrigation (PUI) using IrriSafeTM, laser-activated irrigation (LAI) using Er:Cr: YSGG in comparison to conventional needle irrigation (CNI) in participants diagnosed with symptomatic irreversible pulpitis (SIP). In this randomised double-blinded parallel trial, 75 participants requiring root canal treatment in mandibular first molars diagnosed with SIP were enrolled. A 10 cm visual analogue scale (VAS) was used for pain assessment and patients presented with a preoperative pain score of 5 cm and above were only selected. After biomechanical preparation, the final irrigation protocols varied based on the irrigation protocol employed. In CNI, intracanal irrigation was conducted without agitation using a 31G side vented needle. In PUI, irrigant activation was conducted using IrriSafeTM and in LAI, irrigant activation was conducted using a pulsed Er:Cr: YSGG (2940 nm) laser with radial firing tip (RFT - 2). The pain scores and analgesic intake were assessed postoperatively after obturation at 6, 24 and 48 h. A significant reduction in postoperative pain levels and analgesic intake was seen among all groups at assessed time intervals (p<0.05). Overall, mean postoperative pain scores and analgesic intake were CNI>LAI>PUI (p<0.05) respectively. Participants diagnosed with SIP receiving PUI and LAI showed low and comparable levels of postoperative pain scores. Based on the analgesic intake, PUI showed the least analgesic intake when compared to LAI and CNI respectively. Key words:Endodontics, Root canal irrigants, Postoperative Pain, Passive ultrasonic activation, Laser ultrasonic activation.