Single-visit Root Canal Treatment Research Articles

Effect of Cryotherapy and Occlusal Reduction on Postoperative Endodontic Pain in Mandibular First Molars with Symptomatic Apical Periodontitis: A Prospective, Parallel, Double-Blinded Randomized Controlled Trial.

This study aimed to compare the intensity of postoperative pain following the final rinse using cold saline compared with room temperature saline and occlusal reduction. A prospective, parallel, double-blinded randomized controlled trial was conducted on 69 first mandibular molars diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis. Single-visit root canal treatment was performed; access cavity preparations and chemomechanical preparations were carried out using the ProTaper Gold rotary system under copious irrigation using 3% sodium hypochlorite and 17% EDTA. The patients were divided into three groups (n = 23): control group: room temperature saline (25°C) final rinse without occlusal reduction; cryotherapy group: cold saline (2.5-4°C) final rinse without occlusal reduction; and occlusal reduction group: room temperature saline with occlusal reduction. Pain scores were recorded using the visual analog scale preoperatively and postoperatively via telephone at 6, 24, 48, 72 hours, and 7 days intervals. Age data were analyzed using one-way analysis of variance followed by Tukey's post hoc test. Pain score data were analyzed using Kruskal-Wallis' test followed by Dunn's post hoc test for intergroup comparisons and Friedman's test followed by Nemenyi's post hoc test for intragroup comparisons. Correlations were analyzed using Spearman's rank-order correlation coefficient. The significance level was set at p < 0.05 within all tests. Cryotherapy reduced postoperative pain compared with the control group with a statistically significant difference at 24 hours only (p = 0.016). At other intervals, no statistically significant difference in pain score was measured between all three groups (p > 0.05). After 7 days, all patients recorded a zero pain score. Cryotherapy was as effective as the occlusal reduction in reducing postoperative pain in cases of symptomatic irreversible pulpitis with symptomatic apical periodontitis, significantly more than the control group.

Influence of sonic activation of epoxy-resin and calcium silicate sealer on postoperative pain: a patient-blinded, parallel group, randomized clinical trial

BackgroundThis clinical study aims to compare postoperative pain after single-visit root canal treatment of teeth with asymptomatic apical periodontitis using epoxy-resin-based AH Plus and calcium silicate-based Endosequence BC sealers with or without sonic activation.MethodsThis study included 72 individuals with one first or second mandibular premolar tooth with asymptomatic apical periodontitis. They were randomly divided into four groups according to the root canal sealer (AH Plus or Endosequence BC) and activation protocol (sonic activation or non-activation) (n = 18). The participants were ask to rate their postoperative pain intensity on a NRS scale as none, minimal, moderate, or severe after 24 h, 48 h, 72 h, and 7 days following treatment. Patients were also asked to record the number of prescribed analgesic medication tablets (400 mg of ibuprofen) taken. Statistical analysis were performed using the Mann-Whitney U test, the Friedman test, the Spearman’s correlation test, the Chi-square test. Significance level was established at 0.05.ResultsThere was no statistically significant difference in postoperative pain scores or analgesic intake between AH Plus and Endosequence BC sealers regardless of the activation protocol (p > 0.05). There was no statistically significant difference in postoperative pain scores between the sonic activation and non-activation groups (p > 0.05). A weak positive correlation was detected between Endoactivator sonic activation and sealer extrusion (r = 0.36).ConclusionsAH Plus and EndoSequence BC root canal sealers showed similar results in terms of prevalance and intensity of postoperative pain. Sonic activation and non-activation groups had similar postoperative pain scores.Clinical trial registrationThe study was retrospectively registered with ClinicalTrials.gov (NCT06403293). Date of Registration: 07/05/24.

Efficacy of Endodontic Cryotherapy in Alleviating Post-Treatment Pain after Single-Visit RCT: A Randomized Study

ABSTRACT Aim: This study aims to assess whether endodontic cryotherapy can effectively lower discomfort after a single root canal visit. Material and Method: Thirty-six patients aged 18–32 years requiring single-visit root canal treatment (RCT) were divided into three groups at random, with twelve people in each: group 1 (control group), group 2 (normal saline), and group 3 (cold saline). After root canal therapy was finished, group 1 got no further treatment, group 2 got standard saline irrigation at room temperature, and group 3 got cold saline irrigation at 35.6–41°F. A visual analog scale (VAS) was used to measure pain after 6, 12, 24, and 48 hours after therapy. Result: Preliminary results indicated a marked reduction in pain in group 3 relative to groups 1 and 2 at 6, 12, and 24 hours post-treatment (P &lt; 0.05). At 48 hours, pain levels had significantly diminished across all groups, with group 3 consistently exhibiting the lowest VAS scores. Conclusion: Endodontic cryotherapy using cold saline irrigation shows significant efficacy in reducing post-treatment pain after single-visit RCT when compared to normal saline and no additional intervention. These findings suggest that integrating cryotherapy could be a valuable adjunct in endodontic pain management.

Effect of Ascorbic Acid as A Final Flush on Post Operative Pain After Single Visit Root Canal Treatment for Patients with Symptomatic Irreversible Pulpits Related to Mandibular Molars: Randomized Controlled Trial

Effect of Ascorbic Acid as A Final Flush on Post Operative Pain After Single Visit Root Canal Treatment for Patients with Symptomatic Irreversible Pulpits Related to Mandibular Molars: Randomized Controlled Trial

Antibacterial Efficacy of Rotary and Reciprocating Instrumentation Techniques.

To clinically evaluate the effectiveness of rotary (ProTaper Next [PTN]) and reciprocating (Wave One Gold [WOG]) instrumentation techniques in eliminating bacteria from the root canals of teeth with apical periodontitis during a single-visit root canal treatment. Forty patients were randomly assigned to the WOG or PTN instrumentation techniques groups. A single-visit root canal treatment was performed on all the patients. In both groups, root canals were irrigated with 10 ml of sodium hypochlorite (NaOCl) and the final irrigation protocol was applied. Microbiological samples from the root canal were collected initially (Sample 1), after chemo-mechanical instrumentation (Sample 2), and after the final irrigation protocol (Sample 3). Quantification of bacteria at each stage of root canal treatment was performed using the culture method (colony-forming units [CFUs]), and bacterial species were identified using MALDI-TOF mass spectrometry. There were 55 aerobic and anaerobic bacterial species identified. Chemo-mechanical root canal treatment with both instrumentation techniques and the final irrigation protocol significantly reduced the number of CFUs (p<0.001). There were no statistically significant differences in antibacterial efficacy between WOG and PTN groups (p>0.05). Although both root canal instrumentation techniques were highly effective in removing bacteria from the necrotic canals of teeth with chronic apical periodontitis, no complete eradication of bacteria was found in any sample.

Effect of long-acting supplementary local anesthetic on intra and post operative pain in single visit root canal treatment: a randomized control trial

Effect of long-acting supplementary local anesthetic on intra and post operative pain in single visit root canal treatment: a randomized control trial

Patient-related predictors of post-operative pain following root canal treatment: A structural model analysis.

The pathways to post-operative pain are complex and encompass factors that extend beyond the treatment protocol employed. This study aimed to identify patient-related predictors of post-operative pain following root canal treatment. A total of 154 patients received a single-visit root canal treatment for asymptomatic necrotic mandibular molars. Before treatment, dental anxiety, dental fear and sense of coherence (SOC) were measured as predictors for each patient using validated questionnaires. Other measured predictors included gender, age, previous negative experiences at the dental offices and prior root canal treatment. Post-operative pain was assessed using the Numeric Rating Scale at multiple time-points over 30 days. Structural equation analysis was employed to evaluate the direct and indirect effects of patient-related predictors on a theoretical model of post-operative pain. The irrigant solution was also included in the model, as it was the only aspect that varied in the treatment protocol (sodium hypochlorite 2.5% and 8.25%). Dental anxiety (coefficient 0.028; p < .01), dental fear (coefficient 0.007; p = .02) and irrigant solution (coefficient 0.004; p = .03) exerted a direct effect on post-operative pain. SOC exerted an indirect effect on post-operative (coefficient 0.006; p = .01) through dental anxiety and dental fear. Moreover, previous negative experiences (coefficient 0.048; p = .04) exerted an indirect effect on post-operative pain through dental anxiety. Dental anxiety, dental fear, previous negative experiences and SOC are patient-related predictors of post-operative pain following root canal treatment. These factors should be taken into consideration in clinical practice, as patients with these characteristics may be at an increased risk of experiencing post-operative pain.

Postoperative Pain Following Single Visit Root Canal Treatment With Reciproc Blue And Hyflex EDM Instrumentation; A Prospective Randomized Clinical Trial

Objective: Single file systems with continuous rotation or reciprocation produced with many new technologies promising in terms of postoperative pain. The aim of this study was to investigate the efficacy of using novel Reciproc Blue (RBlue) and HyFlex EDM (HEDM) files on postoperative pain after single visit root canal treatment. Materials and Methods: 72 patients with asymptomatic pulp necrosis in mandibular molar and premolar teeth were included. The root canals were prepared using HEDM (n=29) or RBlue (n=28) and hand-instruments (n=15) in single visit. Pain presence using verbal rating scale (VRS) and analgesic intake were recorded after 24h, 48h, 72h and 7 days. Results: Postoperative pain at 24h and 48h was statistically higher at RBlue group than HEDM and control groups (p0.05).There was no difference between groups in terms of analgesic intake (p&gt;0.05). RBlue files were associated with higher incidence of postoperative pain and higher VRS scores than HEDM and hand-instruments. Conclusion: RBlue files working with reciprocating motion caused much more postoperative pain than HEDM files and manual files.

Post-operative pain after single-visit root canal treatment using resin-based and bioceramic sealers in teeth with apical periodontitis: A randomised controlled-trial.

The present study aimed to compare postoperative pain in teeth with symptomatic and asymptomatic apical periodontitis (AP) following a single-visit endodontic treatment using BioRoot™ RCS or AH Plus at 8 h, 24 h and 48 h postoperatively. Postgraduate students performed endodontic treatment on 101 teeth with AP, randomised into two obturation groups. A 100-mm Visual Analog Scale was used to document the intensity of pain at preoperative, 8-h, 24-h and 48-h intervals. The Kolmogorov-Smirnov test was used for normality, and the median and interquartile ranges were compared using the Mann-Whitney U test. Preoperative pain (1.90 ± 3.50) was more frequent in teeth with symptomatic AP (p < 0.05). However, no significant differences were observed in postoperative pain at the 8-h, 24-h and 48-h intervals. Pre and postoperative pain were directly associated (p < 0.05). Single-visit root canal treatment in teeth with AP using both sealers resulted in similar levels of postoperative pain.

Comparative Evaluation of Incidences of Post Operative Pain in Patient Treated in Single Visit Root Canal Treatment by Using Different Sealers: - An in-Vivo Study

Comparative Evaluation of Incidences of Post Operative Pain in Patient Treated in Single Visit Root Canal Treatment by Using Different Sealers: - An in-Vivo Study

Comparative Analysis of Post-operative Pain Relief and Healing Outcomes between Single-Visit and Multiple-Visit Root Canal Therapy: A Tertiary Care Study.

Apical periodontitis and irreversible pulpitis are typical dental conditions treated with "Root Canal Treatment (RCT)". Single-visit RCT has become a viable alternative to the multi-visit RCT method used in traditional RCT. A total of 100 RCT participants were randomised to either the single-visit or multiple-visit groups at random. A "Visual Analogue Scale (VAS)" was used to measure post-operative discomfort at 24, 48, and 72 hours. At 6 and 12 months, peri-apical radiographs were used to assess the healing results. At all time periods, there were no discernible variations in post-operative discomfort between the single-visit and multiple-visit groups. In contrast to the multiple-visit group, the single-visit group had greater rates of full healing at both 6 and 12 months. Compared to multiple-visit RCT, single-visit RCT provides similar post-operative pain alleviation and may result in better healing results. This suggests that single-visit RCT is a feasible and effective management option for patients who need root canal therapy.

The effect of bioactive glass-based, bioceramic based and epoxy amine resin based root canal sealers on post-obturation pain: A double blinded randomized controlled trial.

The aim of this study was to compare the effect of two calcium silicate-based and an epoxy resin-based root canal sealers on postoperative pain and analgesic intake following single-visit root canal treatment. Ninety patients with at least one first or second molar tooth diagnosed as symptomatic irreversible pulpitis and symptomatic apical periodontitis were selected and allocated into three groups (n=30) according to the sealer used. Root canals were prepared using Protaper Gold instruments (Dentsply Sirona) in a crown down technique and irrigated with 2.5% NaOCl (Calyx, India) and saline solution. Root canal filling was then accomplished with a single cone obturation technique and treated in a single visit by the same endodontist. Patients were told to use a Visual Analog Scale (VAS) to rate their postoperative pain severity as none, minimal, moderate, or severe after 6 h, 24 h, 48 h, 5 days and 7 days following obturation using the appropriate sealers. The need for analgesic intake was also recorded. The data were statistically analyzed. Results showed a significant difference among the studied groups. Bio-C Sealer Ion+ reported the least pain score followed by Nishika Canal Sealer BG and AH plus sealer at all the time intervals recorded. The intergroup analysis, revealed was a significant difference in postoperative pain at 6 h (p=0.000) and 24 h (p = 0.028), but not at 48 h, 5 day or 7 days (P > 0.05). VAS ratings for all the three groups decreased over time. Also, there were significant differences between the means of analgesic intake among 3 groups (p=0.022). Analgesic intake in group BIO-C Sealer Ion+ is significantly lesser than AH Plus and Nishika Canal Sealer BG group. Calcium silicate-based sealer (Nishika Canal Sealer BG and Bio-C Sealer Ion+) resulted in significantly lower levels of pain as compared to epoxy resin-based sealer (AH Plus) at 6h and 24-h interval, there was no significant difference in postoperative pain occurrence at 48-h, 5 day and 7-day period. The analgesic intake in Bio-C Sealer Ion+ group is significantly lesser than Nishika Canal Sealer BG and AH Plus group.

Evaluation of Different Root Canal Sealers on Post Operative Pain in Single Visit RCT – A Comparative Study

ABSTRACT Aim: To evaluate and compare three different root canal sealers (Endo-Sequence BC, Bio Root RCS and Zinc Oxide Eugenol) on post operative pain in single visit root canal therapies. Material and Methodology: 60 subjects with age ranging from 18-60 years were randomly selected depending upon the inclusion criteria. The subjects were then divided into three groups with 20 patients in each. In all the patients’ single visit root canal treatment was done followed by obturation using different sealers. In Group I Endo- Sequence sealer was used, in Group II Bio-Root RCS and in Group III Zinc Oxide Eugenol sealers were used respectively. Results: statistically significant results were obtained on comparing the efficacy of three groups with Group I proving to be much effect among the three. Conclusion: within the limitation of the study it can be concluded that though all the sealers were effective in reducing post-operative pain, patients with Endo Sequence BC sealers evaluated statistically significant results.

Cryotherapy as a non pharmacological alternative for the management of postoperative endodontic pain after one visit root canal treatment using three irrigating regimens at different temperatures

Background: The goal of the present study was to assess the effect of cryotherapy application at various temperatures in the reduction of postoperative pain after a single-visit (SV) root canal treatment (RCT). Aim: The present study aimed to evaluate the postoperative pain after intracanal cryotherapy with saline at different temperatures. Methodology: Sixty participants aged ≥18 years were included in this clinical trial. All patients with good general health indicated for SV RCT were included in the present study. Preoperative Visual Analog Scale (VAS) scores were obtained by percussing the tooth, and written consent was obtained. The access cavities were prepared, cleaning and shaping were done, and the patients were allocated into three groups based on final irrigation: Group I – saline at room temperature (37°C) (control group), Group II – cold saline (at 4°C), and Group III – cold saline (at 2.5°C). After drying, the canal obturation was done in the same appointment. Postoperative pain was recorded at 24, 48, and 72 h and 7 days with VAS. In case of severe pain, an analgesic was prescribed. Statistical Analysis Used: The Chi-square test was used to analyze the data. Results: Both cryotherapy irrigation groups showed the lowest postoperative pain at 24, 48, and 72 h and after 7 days. The analgesic intake was higher in Group I as compared to other groups. Conclusion: Cryotherapy is a promising nonpharmacological treatment alternative for postoperative pain in SV RCT.

Assessment of Bacterial Load and Post-Endodontic Pain after One-Visit Root Canal Treatment Using Two Types of Endodontic Access Openings: A Randomized Controlled Clinical Trial.

The need for controlling bacteria and pain during root canal therapy is undeniable. This clinical trial aimed to assess whether there is a difference in colony-forming unit (CFU) reduction after instrumentation and post-endodontic pain after root canal treatment (RCT) using a traditional endodontic cavity (TEC) versus a conservative endodontic cavity (CEC). This clinical study was conducted on 89 patients designated for a single-visit RCT. Patients were allocated randomly (TEC n = 45 and CEC n = 44). The access opening was gained accordingly in each group by a single operator. A pre-instrumentation sample of root canal dentin was collected using an endodontic file; the second sample was collected similarly, right after shaping and cleaning the root canal. The CFU was calculated based on the samples collected. The pain level was recorded preoperatively and at 1, 7, and 21 days postoperatively utilizing a visual analog scale (VAS). There were no statistically significant differences in the CFU reduction between the TEC and CEC groups (p > 0.05). Additionally, there were no statistically significant differences found in postoperative pain levels between the TEC and CEC at 1, 7, and 21 days (p > 0.05). Despite the limitations of this study, both the CEC and TEC demonstrate a decrease in bacteria within the root canals and alleviate postoperative pain with no difference between them.

The effect of ibuprofen sustained release oral premedication on intraoperative and postoperative pain: A randomised clinical trial.

The aim of this study was to assess the effect of ibuprofen sustained release (SR) oral premedication on the efficacy of buccal infiltration (BI) with intraoperative and postoperative pain after single-visit root canal treatment. Sixty patients diagnosed with symptomatic irreversible pulpitis and apical periodontitis in mandibular molar were divided into two groups. Group SR received ibuprofen SR 800 mg and group PL received placebo capsule 1 h before 3.6 mL articaine BI injection. Pain was recorded using a modified visual analogue scale and postoperatively at intervals 6, 24 and 48 h. Group SR showed a significantly higher anaesthetic success rate (73.3%) compared to group PL (46.7%) (p < 0.05). Intraoperative and postoperative pain was significantly higher in group PL compared to group SR (p < 0.05). Premedication of ibuprofen SR improved the efficacy of primary BI in mandibular molars with symptomatic irreversible pulpitis and decreased postoperative pain at 6 and 48 h.

Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial.

To evaluate the intensity of postendodontic pain (PEP) using final irrigation with side-vented needle (SV), EndoActivator (EA), and Ultra X (UX) in single-visit endodontics (SVE) with F-One rotary files. A total 150 patients indicated for endodontic treatment were selected. Single-visit endodontics treatment was performed under local anesthesia. For the final irrigation protocol, they were divided into three groups: group I (SV), group II (EA), and group III (UX). The severity of PEP was assessed using visual analogue scale (VAS) score after 6, 12, 24, and 48 hours. Analgesics taken by patients, for pain, were also recorded. Finally, the data were tabulated and statistically analyzed using SPSS 20.0 software at a level of significance being 0.05. Postendodontic pain was less in group III (UX) and group II (EA) compared with group I (SV) at 6 and 12 hours, which is statistically significant (p < 0.05). There was no statistically significant difference found after 24 hours and 48 hours. The intensity of PEP was minimum in patients treated with EndoActivator and ultrasonic along with single rotary file systems. The incidence of analgesic intake was similar in all three groups. How to cite this article: Kathiria NV, Attur K, Bagda KM, et al. Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial. J Contemp Dent Pract 2024;25(2):180-185.

Postoperative Pain Following Single-visit Root Canal Treatment with Reciproc Blue and HyFlex EDM Instrumentation; A Prospective Randomized Clinical Trial

Postoperative Pain Following Single-visit Root Canal Treatment with Reciproc Blue and HyFlex EDM Instrumentation; A Prospective Randomized Clinical Trial

Diclofenac Transdermal Patch versus Oral Diclofenac on Post Endodontic Pain and Quality of Life- A Randomised Clinical Trial.

To compare the effect of pre-treatment transdermal and oral diclofenac on post-endodontic pain level and oral health-related quality of life (OHRQOL) in patients with symptomatic irreversible pulpitis with apical periodontitis in mandibular molars following single visit root canal treatment. This parallel-arm, randomised, double-blinded clinical trial is reported according to the Consoli-dated Standards of Reporting Trials (CONSORT) 2020 guidelines. The protocol was approved by the Institu-tional Ethical Committee on 30th March 2021 (MADC/IEC-I/029/2021) and registered at the clinical trial reg-istry of India (CTRI/2021/12/038696). Adult patients fulfilling the eligibility criteria were randomised into two groups. Group DTP received a diclofenac transdermal patch 100 mg, and Group DOT received a diclofenac oral tablet 100 mg one hour before root canal treatment. Pain scores were checked at baseline, 2, 4, 6, 8, 24, 48, and 72 hours after the treatment. OHRQOL was assessed at baseline and one week after the treatment. Both groups were associated with a significantly lower incidence of post-operative pain and im-proved OHRQOL. At 2 hours, the pain level was significantly lower with an oral diclofenac tablet, and at 24 hours, the pain level was significantly lower with a diclofenac transdermal patch. Regarding OHRQOL, there was no significant difference between the two groups. Within the limitations of this study, the diclofenac transdermal patch had lesser post-operative pain at 24 hours, whereas the oral diclofenac tablet had lesser pain at 2 hours.

Comparative evaluation of effect of intracanal cryotherapy and corticosteroid solution on post endodontic pain in single visit root canal treatment.

Post-operative pain after endodontic treatment is a common occurrence, and its prevalence is mostly high immediately after treatment, decreasing in one day and reportedly reaching minimal levels 7 days after treatment. This research focuses on the final flushing of the root canal with different irrigating solutions to reduce its occurrence. Aim: To compare and evaluate the effect of delivering three intracanal irrigants - saline at room temperature, saline at 2.5oC, and intracanal dexamethasone as final irrigant on postoperative pain after a single visit endodontics. This randomized double-blinded parallel clinical trial was conducted on patients requiring a single appointment root canal treatment, with a pain level of 4 or higher on the visual analogue scale (VAS). According to the final irrigating solution, all patients were randomly allocated into three groups of 15 each: 0.9% physiological saline (Group 1), 2.5oC cold saline (Group 2), and 2ml Dexamethasone (Group 3). Patients were instructed to complete VAS to determine their post-operative scores at 6hrs, 12hrs, and 24hrs following the treatment. In all groups, mean VAS scores decreased significantly from baseline to 6hr and 12hr, with lower scores at 24 hours. Post-hoc analysis revealed no significant distinction in the mean VAS scores between 12 hours to 24 hours. Lower pain scores are observed in the dexamethasone group, followed by cryotherapy which performed better than saline at room temperature. Final flushing with dexamethasone solution and cryotherapy is effective, safe, and a well-tolerated strategy to minimize postoperative pain after single visit endodontics. Key words:Intracanal cryotherapy, Cold saline, Dexamethasone, Postoperative pain, Visual analogue scale.