EVALUATION OF POST-OPERATIVE PAIN AFTER IRRIGATION USING END-VENTED NAVITIP TIPS VERSUS SIDE-VENTED NAVITIP TIPS IN TEETH WITH IRREVERSIBLE PULPITIS: A RANDOMIZED CLINICAL TRIAL

  • Masters Degree in Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Egypt.
  • Professor in Endodontics Department, Faculty of Oral and Dental Medicine, Cairo University, Egypt.
  • Lecturer in Endodontics Department, Faculty of Oral and Dental Medicine, Cairo University, Egypt.
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Objectives: The aim of this prospective randomized clinical trial was to compare the degree of post-operative pain and analgesic intake at 0, 4, 12, 24, 48, 72-hrs and 7 days after the use of two different irrigation needles. Subjects and Methods: Thirty eight participants diagnosed with symptomatic or asymptomatic irreversible pulpitis in mandibular posterior teeth received single-visit root canal treatment and were divided randomly into two groups according to the type of needle used during irrigation either NaviTip 29-gauge, 27 mm with End-Vented needle (EVN) or NaviTip 31-gauge, 27 mm with Double Sideport Irrigator Tip (SVN). Post-operative pain was measured using Numeric Rating Scale (NRS) pre-operatively, immediate post-operatively and at 4, 12, 24, 48, 72-hrs and 7 days. Placebo and analgesic intake was recorded at the different time intervals. Results: There was no difference between both groups in the NRS scores at all the post-operative time intervals. An observable increase in pain levels was recorded at 4-hrs followed by an observable drop in pain levels at 12, 24 and 48-hrs post-operatively until pain disappeared at 7 days with no difference in drug intake post-operatively between both groups.

  1. ElMubarak AHH, Abu-bakr NH and Ibrahim YE: Postoperative Pain in Multiple-visit and Single-visit Root Canal Treatment. J Endod. 2010;36(1):36-39.
  2. Sipavičiūtė E and Manelienė R: Pain and flare-up after endodontic treatment procedures. Stomatologija. 2014;16(1):25-30.
  3. Siqueira JF and Barnett F: Interappointment pain : mechanisms , diagnosis , and treatment. Endod Top 2004:93-109.
  4. Van Der Sluis LWM, Versluis M, Wu MK and Wesselink PR: Passive ultrasonic irrigation of the root canal: A review of the literature. Int Endod J. 2007;40(6):415-426.
  5. de Gregorio C, Estevez R, Cisneros R, Paranjpe A and Cohenca N: Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: An in vitro study. J Endod. 2010;36(7):1216-1221.
  6. Shen Y, Gao Y, Qian W, et al: Three-dimensional Numeric Simulation of Root Canal Irrigant Flow with Different Irrigation Needles. J Endod. 2010;36(5):884-889.
  7. Chopra S, Murray PE and Namerow KN: A Scanning Electron Microscopic Evaluation of the Effectiveness of the F-file versus Ultrasonic Activation of a K-file to Remove Smear Layer. J Endod. 2008;34(10):1243-1245.
  8. Seltzer S and Naidorf IJ: Flare-ups in endodontics: I. Etiological factors. J Endod. 1985;11(11):472-478.
  9. Yeter KY, Evcil MS, Ayranci LB and Ersoy I: Weight of apically extruded debris following use of two canal instrumentation techniques and two designs of irrigation needles. Int Endod J. 2013;46(9):795-799
  10. Wang SH, Chung MP, Cheng JC, Chen CP and Shieh YS: Sodium hypochlorite accidentally extruded beyond the apical foramen. J Med Sci. 2010;30(2):61-65.
  11. Gondim E, Setzer FC, Dos Carmo CB and Kim S: Postoperative Pain after the Application of Two Different Irrigation Devices in a Prospective Randomized Clinical Trial. J Endod. 2010;36(8):1295-1301.
  12. Al-Zaka IM. and Al-Zaka IM: The incidence of pain after root canal treatment using different irrigation methods. Tikrit J Dent Sci. 2012;1:38-43.
  13. Sathorn C, Parashos P and Messer H: 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.
  14. Fox J, Atkinson JS, Dinin AP, et al: Incidence of pain following one-visit endodontic treatment. Oral Surg Oral Med Oral Pathol. 1970;30(1):123-130.
  15. Georgopoulou M, Anastassiadis P and Sykaras S: Pain after chemomechanical preparation. Int Endod J. 1986;19(6):309-314.
  16. Al? A, Olivieri JG, Duran-Sindreu F, Abella F, Roig M and Garca-Font M: Influence of preoperative pain intensity on postoperative pain after root canal treatment: A prospective clinical study. J Dent. 2016;45:39-42.
  17. Pandis N: The evidence pyramid and introduction to randomized controlled trials. Am J Orthod Dentofac Orthop. 2011;140(3):446-447.
  18. Chung JH, Kang DH, Jo JK and Lee SW: Assessing the quality of randomized controlled trials published in the Journal of Korean Medical Science from 1986 to 2011. J Korean Med Sci. 2012;27(9):973-980.
  19. Henry MA and Hargreaves KM: Peripheral Mechanisms of Odontogenic Pain. Dent Clin North Am. 2007;51(1):19-44.
  20. Mart?n-Gonz?lez J, Echevarr?a-P?rez M, S?nchez-Dom?nguez B, et al: Influence of root canal instrumentation and obturation techniques on intra-operative pain during endodontic therapy. Med Oral Patol Oral Cir Bucal. 2012;17(5):e912-8
  21. Ashraf H, Kazem M, Dianat O and Noghrehkar F: Efficacy of articaine versus lidocaine in block and infiltration anesthesia administered in teeth with irreversible pulpitis: a prospective, randomized, double-blind study. J Endod. 2013;39(1):6-10.
  22. Wong AW-Y, Zhang S, Li SK-Y, Zhu X, Zhang C and Chu C-H: Incidence of post-obturation pain after single-visit versus multiple-visit non-surgical endodontic treatments. BMC Oral Health. 2015;15:96.
  23. Prashanth MB, Tavane PN, Abraham S and Chacko L: Comparative evaluation of pain, tenderness and swelling followed by radiographic evaluation of periapical changes at various intervals of time following single and multiple visit endodontic therapy: an in vivo study. J Contemp Dent Pract. 2011;12(3):187-191.
  24. Wong AW-Y, Tsang CS-C, Zhang S, Li K-Y, Zhang C and Chu
  25. C-H: Treatment outcomes of single-visit versus multiple-visit non-surgical endodontic therapy: a randomised clinical trial. BMC Oral Health. 2015;15:162.
  26. Figini L, Lodi G, Gorni F and Gagliani M: Single versus multiple visits for endodontic treatment of permanent teeth: a Cochrane systematic review. J Endod. 2008;34:1041-1047.22. Peng L, Ye L, Tan H, Zhou X. Outcome of root canal obturation by warm gutta-percha versus cold lateral condensation: a meta-analysis. J Endod 2007; 33: 106-109.
  27. Fariniuk LF, Baratto-Filho F, Guerisoli DM, Barbizam J V, P?cora JD and Sousa-Neto MD: Modeling capacity of ENDOflash files in simulated root canals. Braz Dent J. 2001;12(1):39-42.
  28. Rejula F, Christalin R, Ahmed W, Dinakaran S, Gopinathan AS and Babu A: Measure and compare the Degree of Root Canal Transportation and Canal-centering ability of Twisted, ProTaper, and Conventional Stainless Steel K Files using Spiral Computed Tomography: An in vitro Study. J Contemp Dent Pract. 2017;18(6):463-469.
  29. Nekoofar MH, Sheykhrezae MS, Meraji N, et al: Comparison of the effect of root canal preparation by using WaveOne and ProTaper on postoperative pain: a randomized clinical trial. J Endod. 2015;41(5):575-578.
  30. Azar NG and Ebrahimi G: Apically-extruded debris using the ProTaper system. Aust Endod J. 2005;31(1):21-23.
  31. Cruz A, Vera J, Gascn G, Palafox-Snchez CA, Amezcua O and Mercado G: Debris Remaining in the Apical Third of Root Canals after Chemomechanical Preparation by Using Sodium Hypochlorite and Glyde: An In?Vivo Study. J Endod. 2014;40(9):1419-1423.
  32. Gon?alves LS, Rodrigues RCV, Andrade Junior CV, Soares RG and Vettore MV: The effect of sodium hypochlorite and chlorhexidine as irrigant solutions for root canal disinfection: A systematic review of clinical trials. J Endod. 2016;42:527-532
  33. Ghisi AC, Kopper PMP, Baldasso FER, et al: Effect of superoxidized water and sodium hypochlorite, associated or not with EDTA, on organic and inorganic components of bovine root dentin. J Endod. 2015;41:925-930.
  34. Siqueira JF, R??as IN, Favieri A and 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.
  35. Haapasalo M, Shen Y, Qian W and Gao Y: Irrigation in Endodontics. Dent Clin North Am. 2010;54:291-312.
  36. Sayin TC, Serper A, Cehreli ZC and Otlu HG: The effect of EDTA, EGTA, EDTAC, and tetracycline-HCl with and without subsequent NaOCl treatment on the microhardness of root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:418-424.
  37. Peng L, Ye L, Tan H and Zhou X: Outcome of root canal obturation by warm gutta-percha versus cold lateral condensation: a meta-analysis. J Endod. 2007;33(2):106-109.
  38. Ferreira-Valente MA, Pais-Ribeiro JLJL and Jensen MP: Validity of four pain intensity rating scales. Pain. 2011;152(10).
  39. Williamson A and Hoggart B: Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14(7):798-804.
  40. Al? A, Olivieri JG, Duran-Sindreu F, Abella F, Roig M and Garc?a-Font M: Influence of preoperative pain intensity on postoperative pain after root canal treatment: A prospective clinical study. J Dent. 2016;45:39-42.
  41. Fernandez C, Reader A, Beck M and Nusstein J: A prospective, randomized, double-blind comparison of bupivacaine and lidocaine for inferior alveolar nerve blocks. J Endod. 2005;31(7):499-503.
  42. Genet JM, Wesselink PR and Thoden van Velzen SK: The incidence of preoperative and postoperative pain in endodontic therapy. Int Endod J. 1986;19(5):221-229.
  43. Damyanov ND, Witter DJ, Bronkhorst EM and Creugers NHJ: Dental status and associated factors in a dentate adult population in bulgaria: a cross-sectional survey. Int J Dent. 2012;2012:578401.
  44. Tang Z, Wang H and Jiang S: Clinical study of single-visit root canal treatment with a nickel-titanium (Ni-Ti) rotary instrument combined with different ultrasonic irrigation solutions for elderly patients with chronic apical periodontitis. Biomed Mater Eng. 2015;26 Suppl 1:S311-8.
  45. Yoldas O, Topuz A, Is?i AS and Oztunc H: Postoperative pain after endodontic retreatment: single- versus two-visit treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98(4):483-487.125.
  46. Al-Negrish ARS and Habahbeh R: Flare up rate related to root canal treatment of asymptomatic pulpally necrotic central incisor teeth in patients attending a military hospital. J Dent. 2006;34(9):635-640.
  47. Uzunoglu E, Turker SA and G?rduysus M: Effects of Different Rotary Files Combined with Different Irrigation Needles on Apically Extruded Debris. Braz Dent J. 2015;26(4):347-350.
  48. Altundasar E, Nagas E, Uyanik O and Serper A: Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(4):31-5.
  49. Epstein JB: Understanding placebos in dentistry. J Am Dent Assoc. 1984;109(1):71-74.
  50. Pochapski MT, Santos FA, de Andrade ED and Sydney GB: Effect of pretreatment dexamethasone on postendodontic pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(5):790-795
  51. Parirokh M, Jalali S, Haghdoost AA and Abbott PV: Comparison of the effect of various irrigants on apically extruded debris after root canal preparation. J Endod. 2012;38(2):196-199.

[Fatma Hany Mohamed, Angie Galal Ghoneim and Sherief Adel Elkhodary (2020); EVALUATION OF POST-OPERATIVE PAIN AFTER IRRIGATION USING END-VENTED NAVITIP TIPS VERSUS SIDE-VENTED NAVITIP TIPS IN TEETH WITH IRREVERSIBLE PULPITIS: A RANDOMIZED CLINICAL TRIAL Int. J. of Adv. Res. 8 (Feb). 1066-1073] (ISSN 2320-5407). www.journalijar.com

Fatma Hany Mohamed
Master’s Degree in Endodontics, Faculty of Oral and Dental Medicine, Cairo University, Egypt.

DOI:

Article DOI: 10.21474/IJAR01/10547      
DOI URL: https://dx.doi.org/10.21474/IJAR01/10547

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