Comparison of Postoperative Pain Levels after Root Canal Instrumentation with Two Rotary Nickel Titanium Instruments (An In-Vivo Study)

Abstract

Up to the moment, post endodontic pain is an inevitable event after root canal preparation and obturation. Various factors have been thought to affect the level of post endodontic pain. Many studies have investigated those factors in order to come up with a predictive model of post endodontic pain. Those factors could be classified into : patient related factors (age, gender, medical history) and tooth related factors (type, number of canals, pulp vitality, periapical status,etc). Many rotary file systems in the market have been tested and compared clinically to evaluate their effect on the levels of post endodontic pain in an attempt to conclude which would result in less pain and thus more patient convenience. The present study aimed to compare and evaluate the post- endodontic pain after instrumentation of the root canals with ProTaper Gold TM rotary file system to KontrolFlexTM rotary file system. This study included 70 patients whom were examined clinically and radiographically to ensure eligibility. After detailed medical and dental history recording, patients received root canal treatment in a single visit. Patients were randomly allocated to two groups to receive root canal instrumentation with either system. Profound anesthesia was ensured with 4% Articaine administered in an inferior alveolar nerve block injection. All steps of the procedure were done under rubber dam isolation. Canals were preflared with ENDOPENER file and negotiated with K-files Sizes 10 and 15. Working length was recorded using the electronic apex locator. Canals were then instrumented with either system and disinfected with 2.5% sodium hypochlorite irrigation delivered in a side vented needle. Canals were then dried using absorbent paper points and obturated with Gutta percha cones and AH plus sealer used in lateral condensation technique. Patients were asked to evaluate their pain levels after 6hrs, 12hrs, 24hrs, 48hrs and 72hrs using the visual analogue scale. Patients were instructed how to use the Visual Analogue Scale to record their pain level. A phone call was made to the patient at all follow up stages to ensure on time recording of the pain level.