Abstract
Objective: To analyse the influence of root canal instrumentation and obturation techniques on intra-operative pain experienced by patients during endodontic therapy. Method and Materials: A descriptive cross-sectional study was carried out in Ponferrada and Sevilla, Spain, including 80 patients (46 men and 34 women), with ages ranged from 10 to 74 years, randomly recruited. Patient gender and age, affected tooth, pulpal diagnosis, periapical status, previous NSAID or antibiotic (AB) treatment, and root canal instrumentation and obturation techniques were recorded. After root canal treatment (RCT), patients completed a 10-cm visual analogue scale (VAS) that ranked the level of pain. Results were analysed statistically using the Chi-square and ANOVA tests and logistic regression analysis. Results: The mean pain level during root canal treatment was 2.9 ± 3.0 (median = 2) in a VAS between 0 and 10. Forty percent of patients experienced no pain. Gender, age, arch, previous NSAIDs or AB treatment and anaesthetic type did not influence significantly the pain level (p > 0.05). Pain during root canal treatment was significantly greater in molar teeth (OR = 10.1; 95% C.I. = 1.6 - 63.5; p = 0.013). Root canal instrumentation and obturation techniques did not affect significantly patient’s pain during root canal treatment (p > 0.05). Conclusion: Patients feel more pain when RCT is carried out on molar teeth. The root canal instrumentation and obturation techniques do not affect significantly the patients’ pain during RCT. Key words:Anaesthesia, endodontic pain, pulpitis, root canal instrumentation, root canal obturation, rotary files.
Highlights
Root canal therapy is one of the most common procedures [1], as well as one of the most feared dental procedures [2]
When multivariate logistic regression analysis was run (Table 4) with tooth type, pulp vitality, irreversible pulpitis, acute apical periodontitis, previous NSAIDs, root canal instrumentation technique and root canal obturation technique as covariates, only tooth type (OR = 10.1; 95% C.I. = 1.6 - 63.5; p = 0.013) remained significantly associated with increased risk e914
As long as we know, no studies are available on the effect of root canal instrumentation and obturation techniques on the pain experienced by patients during endodontic therapy
Summary
Root canal therapy is one of the most common procedures [1], as well as one of the most feared dental procedures [2]. Managing the pain and distress of patients can be frustrating, especially when the root canal treatment (RCT) itself appears to initiate its onset. Mechanical factors, including root canal instrumentation techniques [6,7,8], overinstrumentation or extrusion of root-filling materials [9], have been associated to the presence of post-operative pain. Endodontic patients usually associate fear of pain with the procedure itself, not with the post-treatment period [10]. No data is available on the effect of root canal instrumentation and obturation techniques, on intra-operative pain during RCT. The aim of this study was to analyse the influence of root canal instrumentation and obturation techniques on intra-operative pain experienced by patients during endodontic therapy
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