Visit Root Canal Treatment Research Articles

The Effect of Passive Ultrasonic Irrigation or XP-Endo Finisher on Post-Operative Pain in Patients with Necrotic Teeth with Apical Periodontitis (Randomized Controlled Clinical Trial)

Objective To evaluate the effect of passive ultrasonic irrigation or XP-Endo Finisher on post-operative pain in patients with necrotic teeth with apical periodontitis using (VAS) scale at 6, 12, 24, 48, 72 hours, and 7 day time intervals.
 Methods Seventy-eight patients diagnosed with necrotic mandibular first molar with symptomatic apical periodontitis were randomly allocated into 1 of 3 separate groups (n=26); Navitip group (control), XP-Endo Finisher group, or Ultra X group. After a single visit root canal treatment and a specific method of agitation, depending on each group, the patients were given a questionnaire on which the patient would mark the degree of pain in a scale from 0 to 10 at 6, 12, 24, 48, 72 hours and 7 days post-obturation. Data were statistically analyzed with a significance level of P ≤ 0.05.
 Results Ultrasonic agitation and XP-Endo Finisher agitation as a final irrigation protocol showed significantly lower pain values than the control group, but there was no significant difference in pain values between the experimental groups.
 Conclusion There was significantly less pain associated with ultrasonic and XP-Endo Finisher agitation compared to Navitip irrigation.

Effectiveness of Intracanal Cryotherapy using Different Irrigants on Reduction of Post Endodontic Pain – A Systematic Review and Meta-analysis

Introduction: Recently the non-pharmacological management of post endodontic pain has been extensively studied. The aim of this systematic review was to evaluate the effectiveness of intracanal cryotherapy in reducing postoperative endodontic pain. A comprehensive search was conducted by accessing electronic databases like PubMed, Google Scholar, Google and EBSCO. Articles evaluating the effect of intracanal cryotherapy in reducing postoperative pain using different irrigating agents which were published till November 2020 were included in the study. Risk of bias was assessed using the Cochrane risk of bias criteria. Meta-analysis was performed for ten studies and tested the heterogeneity using I2 index. Qualitative and quantitative analysis was done for thirteen and ten studies respectively. Intracanal cryotherapy was found to be effective in reducing post-operative pain at 6 hours and 24 hours. Within the limitations of the study, it can be concluded that intracanal cryotherapy using cold saline or 17% EDTA at a temperature range of 2.5°C to 6°C as final irrigating agent helps in reducing postoperative pain at 6 hrs and 24 hrs following single-visit or multi visit root canal treatment in teeth diagnosed with irreversible pulpitis with apical periodontitis.

Comparative Evaluation of Preemptive and Preventive Analgesic Effect of Oral Ibuprofen in Single Visit Root Canal Treatment- A Prospective Randomised Pilot Study.

ObjectiveAdequate pain management is an essential key to success in endodontics. The present study aimed to evaluate the postoperative pain levels and analgesic intake on preemptive versus preventive oral administration of ibuprofen in single visit root canal treatment.MethodsA total of 100 participants presented with symptomatic irreversible pulpitis and with severe baseline pain scores were selected for the study. The participants were randomly allocated into two groups as follows: Group I: preemptive group (n=50), Group II: preventive group (n=50). Participants in group I were administered preoperatively with 600 mg of ibuprofen tablet 1 hour before the procedure, whereas in group II, participants were administered only with a placebo preoperatively. The treatment was finished in a single visit, and 200 mg ibuprofen tablet was administered every eight hours in both groups. The participants were asked to take tablets only when required and evaluated for pain scores and analgesic intake at 6, 24, 48, 72 hour intervals.ResultsThere was a statistically significant decrease (P<0.05) in both the pain levels and tablet intake in the preemptive group compared to the preventive group at 6, 24, 48 and 72 hours. Preemptive group was beneficial in reducing postoperative pain scores and analgesic intake at all time intervals.ConclusionPreemptive analgesic administration seems beneficial in reducing postoperative pain levels and analgesic intake in single visit root canal treatment.

Effectiveness of Single Dose Premedication of Piroxicam and Prednisolone on Post Endodontic Pain in One Visit Root Canal Treatment: A Randomized Clinical Trial.

The objective of this study was to compare the effectiveness of premedication drugs including single dose Piroxicam and Prednisolone in regard to post endodontic pain at different time intervals (24, 48, 72 and 96 hours) after single visit root canal treatment. This randomized clinical trial (registration no. NCT04124822) was performed in operative dentistry department of a private clinical institute. One hundred twenty patients identified with symptomatic irreversible pulpitis were included in the study. The pain intensity levels were marked through the use of visual analog scale (VAS) before the commencement of treatment. The participants were randomly allocated in three groups, Group I (n=40) received no medication (control), Group II (n=40) received Piroxicam (20 mg) and Group III (n=40) received Prednisolone (20 mg). The drugs were administered thirty minutes before the endodontic procedure was initiated. Root canal treatmentwas carried out followed by placement of provisional restoration in a single appointment. The patients were instructed to continue marking their pain intensity levels after 24, 48, 72 and 96 hours using VAS. All patients were called for follow up after 4 days for clinical evaluation and the placement of permanent restoration. The effectiveness of each drug over different time interval was studied employing ANOVA test. The significance level was set at P≤0.05. The results of the present study revealed that a higher percentage of patients in all 3 groups, reported no post-operative pain at all evaluated time durations (24, 48, 72, and 96 hours). However, the long term effectiveness (96 hours) of both drugs to reduce post-endodontic pain was observed to be statistically insignificant. There was no significant difference in demographic data in terms of age (P=0.14), gender (P=0.12), whilst tooth type (P≤0.05) showed statistically significant value. Pre-medication with either single dose piroxicam or prednisolone was able to prevent post-endodontic pain in patients with symptomatic irreversible pulpitis.

Comparative Evaluation Of Post-Operative Pain Following Single Visit Root Canal Treatment

Comparative Evaluation Of Post-Operative Pain Following Single Visit Root Canal Treatment

Comparative evaluation of inter appointment pain and analgesic intake with calcium hydroxide and triple antibiotic paste as intracanal medicaments in patients with apical periodontitis a randomized controlled single-blinded clinical trial

Objective: This study aimed to evaluate the effect of calcium hydroxide and triple antibiotic paste as intracanalmedication on the interappointment pain at 8, 24, and 48 hours postoperatively in patients with symptomaticapical periodontitis undergoing multiple visit root canal treatment. Material and Methods: Two hundred andseven systemically healthy patients under the age group of 18-45 years with mandibular molars presenting withsymptomatic apical periodontitis which require root canal treatments were included in this study. After accesscavity preparation, cleaning and shaping was done till ISO 25 size file, and the patients were randomized intothree groups (each group of 69 samples). Group I: no medicament, group II: calcium hydroxide and group III:triple antibiotic paste (TAP). Postoperative pain was evaluated at 8 hours, 24 hours and 48 hours. Results:The results showed that at 8 hours, 24hours and 48hours, there was a statistical difference between I and III(p &lt; 0.05); and Group III and Group II (p &lt; 0.05). Within the group, there was a statistical difference at alltime points IN Group I and II (p &lt; 0.05) except between 24 hours and 48 hours in the Group III (p &gt; 0.05).Conclusion: Within the limitations of this study, TAP was more effective than calcium hydroxide in relievingpain and reducing the analgesic intake at the first 24hours.KEYWORDSIntracanal medicament; Calcium hydroxide; Triple antibiotic paste; Interappointment pain; Apical periodontitis.

Single Visit Root Canal Treatment: Intensity of Postoperative Pain Using AH Plus Sealer Versus Endosequence BC Sealer in Patients with Asymptomatic Apical Periodontitis (A Randomized Clinical Trial)

Single Visit Root Canal Treatment: Intensity of Postoperative Pain Using AH Plus Sealer Versus Endosequence BC Sealer in Patients with Asymptomatic Apical Periodontitis (A Randomized Clinical Trial)

Comparison of Effects of Different Endodontic Irrigating Solutions on Post-Operative Pain during Single Visit RCT

Aims: Comparing the effects of normal saline, 5.25% sodium hypochlorite and 2% chlorhexidine on the post-operative pain intensity after a single visit root canal treatment. Methods: A total of 120 male and female patients requiring an endodontic treatment for necrotic teeth with chronic apical periodontitis were randomly divided into three equal groups (40 each) according to the type of root canal irrigating solution, i.e. group A (normal saline {NaCl}), group B (sodium hypochlorite {5.25% NaOCl}) and group C (chlorhexidine {2.0% CLX}) . The post-operative pain intensity was determined using a self-explanatory questionnaire with four-point pain intensity scale at 6 hrs and 24 hrs and on 4th, 7th and 10th day after a single visit endodontic procedure. Tukey’s test was used to compare significant pain intensity among three root canal irrigating solution. Results: Among group A (NaCl) participants, most of them experienced mild pain at 6th hr. The mean pain score was further compared among the three irrigant groups at different time intervals by Post hoc comparison using Tukey’s HSD test, which showed that group A (NaCl) had a significant difference (p ≤ 0.05) with a mean pain value of 0.66±1 at 6th hr post-endodontic pain determination as compared to group B (5.25% NaOCl) and group C (2.0% CLX) where the mean pain value was 1.05±0.91 and 2.48±0.55 respectively. Conclusion: The present study concludes that normal saline should not be used as the sole root canal irrigant during the endodontic treatment especially when the involved teeth are having necrotic pulp and chronic peri-radicular periodontitis to avoid the incidence of post-endodontic pain. Keywords: Endodontics, Irrigant, Pain, Chlorhexidine.

The Use of Single Length Technique for Single Visit Root Canal Treatment on Molar Mandibula: A case report

Obje ctive : This case report describe the one visit root canal treatment on molar mandibula using a single length technique. Methods : A 28 year old male came to RSGMP with complaints of caries and pain on lower back teeth, positive on cold thermal stimuli, negative on percussion and palpation. Radiographs show caries has reached the pulp chamber. Result : Root canal were treated with single visit endodontic treatment used single length technique, with composite direct restoration. There were no subjective and objective complaints after 1 week control. Conclusion: The use of single length technique on single visit endodontic treatment gives good and efficient result.

ANALGESIC EFFECT OF PRE-EMPTIVE ORAL NSAIDS ON POST-ENDODONTIC PAIN LEVELS IN SINGLE VISIT ENDODONTICS -A SYSTEMATIC REVIEW

Background: Pre-emptive analgesia is an anti-nociceptive treatment which reduces the postoperative pain by preventing the processing of altered afferent input. As most of the patients present with pain preoperatively have higher levels of released local inflammatory mediators. Thus, pretreatment analgesia decreases the establishment of central sensitization, a mechanism by which spinal neurons increase their response to peripheral nociceptive impulse. Objective: This systematic review aims to compare and evaluate the postoperative pain levels and analgesic intake on preoperative oral administration of NSAIDs in single visit root canal treatment. Data Sources: The present review was done according to PRISMA guidelines and was registered in the PROSPERO (Centre for Reviews and Dissemination University of York; http://www.crd.york.ac.uk/PROSPERO). Registration number - CRD42020195775. The research question was formulated based on the PICO strategy. A comprehensive electronic literature search was conducted across PubMed/Medline, Scopus and Cochrane Database independently by two reviewers. Study Eligibility Criteria: Articles published from January 1990 to May 2019 that focused on preemptive strategies in single visit root canal treatment were included in the present review. Based on specified inclusion and exclusion criteria’s, the selected articles were subjected to quality assessment, and the risk of bias was evaluated. Methods: A total of 6 articles were included, out of which three were hand searched. The overall risk of bias of included studies was moderate, and the study limitations were high. Results: Among the studies included, Ibuprofen was considered as the best drug of choice in single visit endodontics. Limitations: The present review was assessing only the effectiveness of NSAIDs in single visit root canal treatment. But ideally comprehensive literature should search on effectiveness in both single and multiple visit root canal treatments. Conclusion: The present systematic review concluded that ibuprofen was considered to be an effective drug in single visit root canal treatment.

Comparison of the Clinical Efficacy of 2.5% Non-Heated Sodium Hypochlorite and 2.5% Heated Sodium Hypochlorite as Irrigation to Control Postoperative Pain in Single Visit Root Canal Treatment

Objective: To compare the clinical efficacy of 2.5% non-heated sodium hypochlorite and 2.5% heated sodium hypochlorite as irrigation to control postoperative pain in single visit root canal treatment. Study Design: Comparative analytical study Place and Duration: Operative dentistry department of Liaquat University of Medical and Health Sciences, Jamshoro for 6 months duration from March 2017 to September 2017. Material and Methods: A total of 60 patients with single rooted maxillary and mandibular permanent teeth were randomly allocated into two groups. 30 patients were in group A and treated with non heated sodium hypochlorite solution and 30 patients in group B were treated with 2.5% heated sodium hypochlorite solution. In both groups, the level of pain was measured postoperatively after 48 hours by using Heft Parker visual Analog Scale of 10 and information was collected on Performa. Results: The average age of the patients was 28.62±6.06 years. There were 40(66.7%) male and 20(33.3%) female. Pain was reduced in both groups but there were no significant difference in reduction of pain between groups (p=0.640). Conclusion: Severity of pain was not statistically significant between groups. At 48 hours, Pain was reduced in both groups but there were no significant difference in reduction of pain between groups. Heated sodium hypochlorite to relieve postoperative pain, it should be new trend for recommendation for treatment of irreversible pulpitis in single visit root canal treatment. Key Words: Root canal, Heated sodium hypochlorite, Postoperative pain.

Single visit endodontics with associated myths

A successful endodontic treatment depends upon localization, proper chemomechanical preparation of the root canal system, debridement, shaping, disinfection, and three-dimensional obturation of canal system. To achieve this, endodontic therapy used to be performed in multiple visits for complete disinfection of the canals in other words for the better success of endodontic therapy. One-visit endodontic therapy is defined as ‘the conservative non-surgical treatment of an endodontically involved tooth consisting of complete biomechanical cleansing, shaping and obturation of the root canal system during one visit’. The concept of single visit root canal treatment is predicted on the entombing theory, which states that the large number of microorganisms are removed during cleaning and shaping and therefore the remaining bacteria are entombed by the root canal obturation, and it’ll miss the essential elements to survive, nutrition and space. The recent advances, helps the dental practitioners and endodontists to perform the root canal treatment in single visit.

Assessment of post-operative pain with use of rotary and conventional root canal instruments in single and multiple visit root canal treatment

Aim: To compare the post-operative pain after the use of rotary and conventional root canal instruments in single and multiple visit root canal treatment Materials and Method: 168 patients requiring Root Canal Treatment [RCT] in maxillary and mandibular 1st molar were involved in the study. On the basis of vitality and radiographic features two groups were made, multiple visit (Group A n=72), single visit (Group B n=96). Then the patients were randomly divided into 4 subgroups. Subgroup I n=36 (multiple visit conventional RCT), Subgroup II n=36 (multiple visit rotary RCT), Subgroup III n=48 (single visit Conventional RCT) and Subgroup IV n=48 (single visit rotary RCT). In subgroup I &amp; Subgroup III Canal preparation was done with stainless steel K files in step back manner. In subgroup II &amp; Subgroup IV, rotary Protaper Next was used. Irrigation was done with 3 % NaOCl and Ethylenediamine tetraacetic acid (EDTA) alternatively followed by obturation. The postobturation pain was recorded at 6hr, 12hr, 24hr, 1 week using visual analogue scale. Statistical Analysis was done using Tukey HSD Post Hoc Test and ANOVA Test. Results: Within 24 hours there was statistically significant difference between the groups (p&lt; 0.05) but after 7 days no statistically significant difference was there (p&gt;0.05). Conclusion: Patients in the groups either in single and multiple visit experience less postobturation pain if the canal preparation was done with the rotary files at all the time intervals (6hrs, 12hrs, 24hrs ) but after 7 days no statistical difference was found.

Reducing Intervention in the COVID-19 Era: Opportunities for Vital Pulp Treatment

Over the last 12 months, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) virus has emerged as a significant global health problem with extensive repercussions for the practise of dentistry. As the principle transmission-route is via droplet-spread, aerosol-generating dental procedures (AGPs) present an exquisite challenge, which either has to be avoided or performed using strict infection-control measures, which increase the deployment of resources and cost. This new working environment necessitates the adoption of simplified, yet effective procedures that reduce intervention and minimise clinical chair time to short, single visits. Vital pulp treatment (VPT) has emerged as an attractive, technically less-complicated group of biologically-based management strategies that are aimed at maintaining pulp vitality and avoiding root canal treatment (RCT). These procedures are carried out in a strict aseptic environment using a rubber dam and have a reported high success rate, suggesting that they could be considered as effective and simple alternative therapies to relieve pain and avoid multiple visit RCT and other endodontic procedures. The relevance of promoting a simple, predictable and effective alternative to traditional, more complex dentistry has never been more compelling. In this perspective article, the latest advances in VPT are highlighted, along with an analysis of their relative success and compelling reasons why we as dentists should be adopting these treatment approaches. Thereafter, case selection, prognostic factors, techniques, limitations and future prospects of these procedures are discussed.

The Incidence and Intensity of Postendodontic Pain and Flareup in Single and Multiple Visit Root Canal Treatments: A Systematic Review and Meta-Analysis

To assess the incidence and intensity of postendodontic pain and flareup in single and multiple visit root canal treatment (RCT) and determine if the difference between the two is significant, a search of PubMed, Medline, Embase, Cochrane, Scopus and Web of science was conducted. The grey literature was searched using Google Scholar and Saudi digital library. Randomised controlled trials evaluating the incidence and intensity of postendodontic pain and flareup published in English from 1 January 2000 to 15 April 2020 were searched. The PRISMA protocol was followed to select the articles. A random effects model was used for the meta-analysis of the data in the included studies. Twenty-one articles were included in the review. Three compared both the incidence and the intensity, while the rest compared either one of the parameters. Most studies used both hand-driven and rotary instruments and irrigated with sodium hypochlorite. Twelve studies used an intracanal medicament. Although individual studies showed discordant treatment outcomes, the meta-analysis did not reveal any significant difference in the incidence or the intensity of the postendodontic flareup between the single and multiple visit RCT groups. Single or a multiple visit root canal treatment is not an independent determinant for the risk of postendodontic pain or a flareup.

Post-operative Pain after Photo-Active Disinfection (PAD) Supplemented Single Visit Root Canal Treatment in Teeth with Symptomatic Apical Periodontitis

Objective: To observe the incidence of post-operative pain after single-visit Non-Surgical Endodontic Therapy (NSET) in teeth with symptomatic apical periodontitis disinfected with Photo-Activated Disinfection (PAD). Methods: Single-rooted teeth (N=30) with pulp necrosis and symptomatic apical periodontitis were included. Subsequent to chemo mechanical preparation, the teeth were randomly distributed into two groups: group I (n=15) which received calcium hydroxide slurry as an intracanal medicament and group II (n=15) which received PAD and obturation in the same visit. Postoperative pain was recorded at 4, 24, 48 and72 hours using a visual analog pain scale. One-way analysis of variance post hoc Tukey test was used to compare the score. Results: There was a significant reduction in pain after instrumentation in Groups I and II. The pain reduction was more in group I as compared to group II at 4 hours. There was no statistically significant difference seen in both the groups at 24, 48 and 72 hours postoperatively. Conclusion: Application of PAD as an adjunct in single visit NSET has no noticeable difference in pain perception when compared with the use of calcium hydroxide interim dressing in two visits NSET.

Association of Irreversible Pulpitis and Multi Visit Root Canal Treatment.

Association of Irreversible Pulpitis and Multi Visit Root Canal Treatment.

Prevalence of Canal Variations in Mandibular 1st Molar in South Indian Population and Association with Age and Gender

Mandibular first molars are amongst the most common teeth requiring endodontic treatment due to their early emergence in the oral cavity and subsequent caries. Proper knowledge and understanding of the root canal morphology and anatomy of mandibular first molars, will help the clinician in developing a proper and standard treatment protocol by predicting possible variations that potentially challenge the treatment outcome. The main objective of the present study was to know the prevalence of canal variations in mandibular 1st molar among the South Indian population and its association with age and gender. All the patients who reported during June 2019 to March 2020 for mandibular 1st molar endodontic therapy were chosen for the study. Information was collected from the dental hospital record system and the resulting data was tabulated in excel and imported to SPSS for correlation and association. Within the limits of the study, the results obtained are: prevalence of canal variations is 7.6% and 2.2% in single and multi visit root canal treatment respectively with a higher incidence among the male patients and it is primarily seen in the age group of 21 to 40 years. This knowledge about the canal variations in the South Indian population will be helpful to the clinician to look for any unusual anatomy while performing endodontic therapy which will prevent any unwanted procedural errors. It necessitates the careful negotiation and cleaning of all accessible canal spaces.

Technical quality and postoperative pain of single visit endodontic treatments of chronic apical periodontitis filled by bioceramic sealer

Aims: The aim of this study was to evaluate technical quality and post-operative pain of single visit root canal treatment of chronic apical periodontitis filled by bioceramic sealer. Material and Methods:Fifty-two gutta percha master cone was used for final irrigation activation using alternatively 2.5% NaOCl and 17% EDTA. All canals were filled by single cone of gutta-percha (Endosequence BC pointTM, Brasseler, USA) and bioceramic sealer (Endosequence BC sealerTM, Brasseler, USA). The technical quality of root filling was evaluated by control radiographs, the clinical postoperative pain and the need for analgesic consumption were assessed during one week post-treatment. The data were analyzed using the Mann-Whitney U and chi-square test, the significance was set at P

Management of periradicular pathosis by single visit endodontic treatment using calcium hydroxide and mineral trioxide aggregate based sealer

In this study, 120 teeth having periradicular pathosis were treated with single visit root canal treatment and then obturated with either calcium hydroxide containing sealer or mineral trioxide aggregate based sealer. The healing of periradicular pathosis was examined at 3, 6, and 12 months by clinical and radiological evaluation. Collected data were analyzed with standard statistical methods by using SPSS version- 20. The results showed that at 3 and 6 months, the differences between calcium hydroxide containing sealer or mineral trioxide aggregate based sealer were not statistically significant. However, the healing capability of periapical radiolucency at 12 months between two groups was statistically significant (P=0.03). The final outcome of the clinical and radiological investigation showed successful results of 96.6% and 98.1% in calcium hydroxide and mineral trioxide aggregate group, respectively. In conclusion, both calcium hydroxide and mineral trioxide aggregate based sealers are almost equally effective in single visit root canal therapy for the management of periradicular pathosis.&#x0D; Update Dent. Coll. j: 2020; 10 (2): 10-13