ASSESSMENT OF POSTOPERATIVE PAIN AFTER SINGLE-VISIT VERSUS MULTIPLE-VISIT ROOT CANAL TREATMENT USING DIFFERENT IRRIGANTS
Main Article Content
Keywords
Postoperative pain; Root canal treatment; Single-visit endodontics; Multiple-visit endodontics; Sodium hypochlorite; Chlorhexidine; Irrigants; Visual analogue scale; Randomized clinical trial; Endodontic flare-up.
Abstract
Postoperative pain following root canal treatment remains a common patient concern and may be influenced by the number of visits and irrigant used during chemomechanical preparation.
Aim:
To evaluate and compare postoperative pain after single-visit and multiple-visit root canal treatments using two different irrigants: 5.25 % sodium hypochlorite (NaOCl) and 2 % chlorhexidine (CHX).
Materials and Methods:
A randomized controlled clinical trial was conducted on 300 patients requiring primary endodontic therapy. Participants were divided into four groups (n = 75 each): single-visit + NaOCl, single-visit + CHX, multiple-visit + NaOCl, and multiple-visit + CHX. Postoperative pain was assessed using a 100 mm visual analogue scale (VAS) at 6, 12, 24, 48, and 72 hours. Analgesic use and flare-ups were recorded. Statistical analysis included ANOVA, chi-square, and two-way ANOVA tests with p < 0.05 considered significant.
Results:
Single-visit groups demonstrated significantly higher pain scores at 6 h and 12 h (p < 0.05), which diminished by 24 h. No significant differences were observed between irrigants. Analgesic use and flare-ups were minimal and comparable among groups.
Conclusion:
Both single- and multiple-visit root canal treatments are safe and effective. Multiple-visit protocols may reduce early postoperative pain, while irrigant type exerts minimal influence on pain outcomes.
References
2. Siqueira JF Jr, Rôças IN, Favieri A, Lima KC. Chemomechanical reduction of the bacterial population in the root canal after instrumentation and irrigation with 1%, 2.5%, and 5.25% sodium hypochlorite. J Endod. 2000;26(6):331-334.
3. Pak JG, White SN. Pain prevalence and severity before, during, and after root canal treatment: a systematic review. J Endod. 2011;37(4):429-438.
4. Sathorn C, Parashos P, Messer HH. The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review. Int Endod J. 2008;41(2):91-99.
5. Figini L, Lodi G, Gorni F, Gagliani M. Single versus multiple visits for endodontic treatment of permanent teeth. Cochrane Database Syst Rev. 2007;(4):CD005296.
6. Wong AWY, Zhang C, Chu C-H, et al. A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment. Clin Cosmet Investig Dent. 2014;6:45-56.
7. Nekoofar MH, et al. Comparison of single and multiple visit endodontic treatment: a systematic review and meta-analysis. J Endod. 2017;43(5):732-743.
8. AlRahabi MK. Evaluation of postoperative pain following single-visit and multiple-visit root canal treatment in infected root canals: a randomized clinical trial. Eur J Dent. 2017;11(4):559-564.
9. Mulay S, Ali SG, Sejpal D, Palekar A. Incidence of flare-ups after single-visit versus multiple-visit endodontic treatment: a randomized clinical study. J Conserv Dent. 2012;15(3):237-240.
10. Mohammadi Z, Abbott PV. Antimicrobial substantivity of chlorhexidine and calcium hydroxide-containing medicaments in root canal dentin. Aust Endod J. 2009;35(1):31-35.
11. Siqueira JF Jr, Rôças IN. Mechanisms of endodontic pain: microbial and inflammatory interactions in periapical tissues. Int Endod J. 2014;47(7):611-619.
12. Ng YL, Glennon JP, Setchell DJ, Gulabivala K. Prevalence of and factors affecting postoperative pain in endodontic treatment. Int Endod J. 2004;37(6):381-391.
13. de Oliveira BP, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Effect of irrigant activation techniques on postoperative pain in endodontic treatment: a systematic review. Aust Endod J. 2020;46(3):298-307.
14. Niazi SA, et al. Association between endodontic infection, its treatment and systemic implications. Medicina (Kaunas). 2022;58(7):931.
15. Holland R, de Souza V, Nery MJ, et al. Factors affecting the periapical healing process of endodontic lesions: a review. Int Endod J. 2017;50(9):800-807.
16. Shaik RP, Chukka RS, Bandlapally A, et al. Assessment of postoperative pain after single-visit root canal treatment using rotary and reciprocating file systems: an in vivo study. J Dent Anesth Pain Med. 2022;22(4):267-275. doi:10.17245/jdapm.2022.22.4.267
17. Alonso-Ezpeleta LO, Gasco-Garcia C, Castellanos-Cosano L, Martín-González J, López-Frías FJ, Segura-Egea JJ. Postoperative pain after one-visit root-canal treatment on teeth with vital pulps: 3 comparison of three different obturation techniques. Med Oral Patol Oral Cir Bucal. 2012;17:e721–e727. doi: 10.4317/medoral.17898
18. Goreva LA, Petrikas AZh. [Postobturation pain associated with endodontic treatment] Stomatologiia (Mosk) 2004;83:14–6
19. Makeeva IM, Turkina AIu. [Effects of the method of mechanical root canal treatment on emergence of pain after endodontic management] Stomatologiia (Mosk) 2005;84:21–3.
20. Seltzer S. Pain in endodontics. J Endod. 2004;30:501–3. doi: 10.1097/00004770-200407000-00010.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Omkar Eswara Babu Danda
MDS, Conservative Dentistry & Endodontics, Senior Lecturer, care dental College, Andhra Pradesh, India.
Dr Jitendra Sharan
MDS, Ph.D. PGDDE Professor (Associate) at All India Institute of Medical Sciences Bhubaneswar, Odisha, India
Dr Tarun Kumar Singh
Associate professor AIIMS, BATHINDA, Punjab, India
Dr.G.V.Mohandas
Associate professor, Department of Anatomy, Maharajas Institute of medical sciences, Nellimerla post, Vizianagaram D. T, Andhra Pradesh, India.
Dr. Afroz kalmee syed
MDS, senior medical writer, writing and publication, Tenali, Andhra Pradesh, India.