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

Abstract

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. 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 72h after treatment. Data were analyzed by Kruskal-Wallis, χ 2, Cochrane Q, one-way ANOVA, and Spearman's correlation analyses (α=0.05). The patients in group 3 reported significantly lower postoperative pain levels at 6, 12, and 18h 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 12h 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). Postoperative pain was significantly lower in patients undergoing root canal instrumentation with the Wave-One file compared with the ProTaper Universal and hand files.