Postoperative pain after one-visit root-canal treatment on teeth with vital pulps: comparison of three different obturation techniques

Luis-O Alonso-Ezpeleta, Carmen Gasco-Garcia, Lizett Castellanos-Cosano, Jenifer Martín-González, Francsico-J López-Frías, Juan-J Segura-Egea, Luis-O Alonso-Ezpeleta, Carmen Gasco-Garcia, Lizett Castellanos-Cosano, Jenifer Martín-González, Francsico-J López-Frías, Juan-J Segura-Egea

Abstract

Objectives: To investigate and compare postoperative pain after one-visit root canal treatment (RCT) on teeth with vital pulps using three different obturation techniques.

Study design: Two hundred and four patients (105 men and 99 women) aged 12 to 77 years were randomly assigned into three treatments groups: cold lateral compaction of gutta-percha (LC), Thermafil technique (TT), and Backfill - Thermafil obturation technique (BT). Postoperative pain was recorded on a visual analogue scale (VAS) of 0 - 10 after 2 and 6 hours, and 1, 2, 3, 4, 5, 6 and 7 days. Data were statistically analyzed using multivariate logistic regression analysis.

Results: In the total sample, 87% of patients experienced discomfort or pain in some moment between RCT and the seventh day. The discomfort experienced was weak, light, moderate and intense in 6%, 44%, 20% and 6% of the cases, respectively. Mean pain levels were 0.4 ± 0.4, 0.4 ± 0.3, and 1.4 ± 0.7 in LC, BT, and TT groups, respectively. Patients of TT group experienced a significantly higher mean pain level compared to other two groups (p < 0.0001). In TT group, all patients felt some level of pain at six hours after RCT.

Conclusions: Postoperative pain was significantly associated with the obturation technique used during root canal treatment. Patients whose teeth were filled with Thermafil obturators (TT technique) showed significantly higher levels of discomfort than patients whose teeth were filled using any of the other two techniques.

Figures

Figure 1
Figure 1
Percentage of patients feeling pain in the total sample and in each treatment group at different periods after root-canal treatment.
Figure 2
Figure 2
Mean pain levels in the total sample and in each treatment group at different periods after root canal treatment.

References

    1. Harrison JW, Baumgartner JC, Svec TA. Incidence of pain associated with clinical factors during and after root canal therapy. Part 2. Postobturation pain. J Endod. 1983 ;9:434–8.
    1. Wang C, Xu P, Ren L, Dong G, Ye L. Comparison of post-obturation pain experience following one-visit and two-visit root canal treatment on teeth with vital pulps: a randomized controlled trial. Int Endod J. 2010;43:692–7.
    1. Pack JG, White SN. Pain prevalence and severity before, during, and after root canal treatment: a systematic review. J Endod. 2011;37:429–38.
    1. Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review. Int Endod J. 2008;41:91–9.
    1. Gondim E Jr, Setzer FC, Dos Carmo CB, Kim S. Postoperative pain after the application of two different irrigation devices in a prospective randomized clinical trial. J Endod. 2010;36:1295–301.
    1. Ng YL, Glennon JP, Setchell DJ, Gulabivala K. Prevalence of and factors affecting post-obturation pain in patients undergoing root canal treatment. Int Endod J. 2004;37:381–91.
    1. Genet JM, Hart AA, Wesselink PR, Thoden van Velzen SK. Preoperative and operative factors associated with pain after the first endodontic visit. Int Endod J. 1987;20:53–64.
    1. Albashaireh ZS, Alnegrish AS. Postobturation pain after single- and multiple-visit endodontic therapy. A prospective study. J Dent. 1998 ;26:227–32.
    1. Eleazer PD, Eleazer KR. Flare-up rate in pulpally necrotic molars in one-visit versus two-visit endodontic treatment. J Endod. 1998 ;24:614–6.
    1. Al-Negrish AR, 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;34:635–40.
    1. Su Y, Wang C, Ye L. Healing rate and post-obturation pain of single- versus multiple-visit endodontic treatment for infected root canals: A systematic review. J Endod. 2011;37:125–32.
    1. Goreva LA, Petrikas AZh. [Postobturation pain associated with endodontic treatment] Stomatologiia (Mosk) 2004;83:14–6.
    1. 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.
    1. Da Silva D, Endal U, Reynaud A, Portenier I, Orstavik D, Haapasalo M. A comparative study of lateral condensation, heat-softened gutta-percha, and a modified master cone heat-softened backfilling technique. Int Endod J. 2002;35:1005–11.
    1. Huskisson EC. Measurement of pain. Lancet. 1974 ;2:1127–31.
    1. Clark DS, ElDeeb ME. Apical sealing ability of metal versus plastic carrier Thermafil obturators. J Endod. 1993 ;19:4–9.
    1. Seltzer S. Pain in endodontics. J Endod. 2004;30:501–3.
    1. Arias A, Azabal M, Hidalgo JJ, de la Macorra JC. Relationship between postendodontic pain, tooth diagnostic factors, and apical patency. J Endod. 2009;35:189–92.
    1. Glennon JP, Ng YL, Setchell DJ, Gulabivala K. Prevalence of and factors affecting postpreparation pain in patients undergoing two-visit root canal treatment. Int Endod J. 2004;37:29–37.
    1. El Mubarak AH, Abu-bakr NH, Ibrahim YE. Postoperative pain in multiple-visit and single-visit root canal treatment. J Endod. 2010;36:36–9.
    1. Vanotti A, Osio M, Mailland E, Nascimbene C, Capiluppi E, Mariani C. Overview on pathophysiology and newer approaches to treatment of peripheral neuropathies. CNS Drugs. 2007;21:3–12.
    1. Wolfe F, Michaud K. The Hawthorne effect, sponsored trials, and the overestimation of treatment effectiveness. J Rheumatol. 2010;37:2216–20.
    1. Attar S, Bowles WR, Baisden MK, Hodges JS, McClanahan SB. Evaluation of pretreatment analgesia and endodontic treatment for postoperative endodontic pain. J Endod. 2008;34:652–5.
    1. Koba K, Kimura Y, Matsumoto K, Watanabe H, Shinoki T, Kojy R. Post-operative symptoms and healing after endodontic treatment of infected teeth using pulsed Nd:YAG laser. Endod Dent Traumatol. 1999 ;15:68–72.
    1. Bagán JV, Soler López, Épico-Study Group. Evaluation of the immediate post-operative procedure after dental interventions. 24 hours follow up study. Epico study. Med Oral Patol Oral Cir Bucal. 2011;16:e573–83.
    1. Scott AC, Vire DE. An evaluation of the ability of a dentin plug to control extrusion of thermoplasticized gutta-percha. J Endod. 1992 ;18:52–7.
    1. Yesilsoy C, Koren LZ, Morse DR, Rankow H, Bolanos OR, Furst ML. Post-endodontic obturation pain: a comparative evaluation. Quintessence Int. 1988 ;19:431–8.
    1. Torabinejad M, Kettering JD, McGraw JC, Cummings RR, Dwyer TG, Tobias TS. Factors associated with endodontic interappointment emergencies of teeth with necrotic pulps. J Endod. 1988 ;14:261–6.
    1. Dummer PM, Hicks R, Huws D. Clinical signs and symptoms in pulp disease. Int Endod J. 1980;13:27–35.
    1. Segura-Egea JJ, Cisneros-Cabello R, Llamas-Carreras JM, Velasco-Ortega E. Pain associated with root canal treatment. Int Endod J. 2009;42:614–20.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner