Postoperative pain intensity and incidence following single visit root canal treatment with different obturation techniques: a randomized clinical trial

Articaine Needle - Free Anesthesia Vs Conventional Anesthesia in Root Canal Treatment of Irreversible Pulpitis in Permanent Teeth: A Prospective Study on Anesthetic Efficacy and Effects on Pain

Objective

This study aimed to compare the anesthetic efficacy of articaine needle-free anesthesia with conventional lidocaine nerve block anesthesia for root canal treatment in permanent teeth with irreversible pulpitis.

Methods

In this prospective clinical trial, 94 patients were randomly allocated to receive either articaine needle-free anesthesia (n=47) or lidocaine nerve block anesthesia (n=47). Anesthetic effectiveness was evaluated through onset time, success rate, and visual analog scale (VAS) pain scores during crown opening and pulp removal procedures. Secondary outcomes included hemodynamic stability (heart rate, systolic and diastolic blood pressure) and incidence of adverse reactions.

Results

The articaine group exhibited significantly faster anesthesia onset (7.62±1.28 minutes vs 9.35±2.04 minutes, p<0.05) and higher success rate (93.62% vs 80.85%, p<0.05). Patients receiving articaine reported significantly lower pain scores during crown opening (4.31±1.13 vs 5.48±1.06) and pulp removal (3.18±1.07 vs 4.26±1.12) (both p<0.05). Both groups maintained comparable hemodynamic stability throughout the procedure (p>0.05), with no significant difference in adverse reaction rates (11.49% vs 10.64%, p>0.05).

Conclusion

Articaine needle-free anesthesia demonstrates superior clinical performance compared to conventional lidocaine nerve block, offering faster onset, improved success rate, and enhanced pain control during root canal treatment of irreversible pulpitis, while maintaining equivalent safety parameters. These findings support its adoption as an effective alternative for dental anesthesia in endodontic procedures.

Post-operative pain after single-visit root canal treatment using resin-based and bioceramic sealers in teeth with apical periodontitis: A randomised controlled-trial

The present study aimed to compare postoperative pain in teeth with symptomatic and asymptomatic apical periodontitis (AP) following a single-visit endodontic treatment using BioRoot™ RCS or AH Plus at 8 h, 24 h and 48 h postoperatively. Postgraduate students performed endodontic treatment on 101 teeth with AP, randomised into two obturation groups. A 100-mm Visual Analog Scale was used to document the intensity of pain at preoperative, 8-h, 24-h and 48-h intervals. The Kolmogorov-Smirnov test was used for normality, and the median and interquartile ranges were compared using the Mann-Whitney U test. Preoperative pain (1.90 ± 3.50) was more frequent in teeth with symptomatic AP (p < 0.05). However, no significant differences were observed in postoperative pain at the 8-h, 24-h and 48-h intervals. Pre and postoperative pain were directly associated (p < 0.05). Single-visit root canal treatment in teeth with AP using both sealers resulted in similar levels of postoperative pain.

Effect of different obturation techniques on treatment results in single-visit non-surgical endodontic retreatment: randomized controlled clinical study

BACKGROUND

Evaluating the effect of different obturation techniques on postoperative pain level and radiographic healing on non-surgical endodontic retreatment (NSER) applied in a single visit in teeth with a single root canal and apical periodontitis (AP).

MATERIALS AND METHODS

Sixty-three teeth from 50 systemically healthy patients (mean age 34.19 ± 9.75 years; 27 women, 23 men) were included in the study. Residual root canal filling materials were removed. All teeth were randomly divided into three groups according to the obturation technique: cold lateral compaction (CLC), continuous wave compaction (CWC), and thermoplasticized gutta-core (TGC). Pain status was evaluated using the Numerical Pain Rating Scale (NRS) in all cases. Periapical index (PAI) scores were recorded in preoperative and postoperative 6-month on the periapical radiographs. Data were analyzed as statistically (IBM, Armonk, NY, USA). The significance level was determined as p < 0.05.

RESULTS

It was found that more postoperative pain occurred in the 3rd-hour interval after CLC and CWC compared to the 7th-day interval (p < 0.05). There was no difference in postoperative pain between obturation techniques in all evaluated time intervals (p > 0.05). There was no difference in the PAI scores recorded at six months between obturation techniques for all periods (p > 0.05). Similar radiographic improvement was observed in all obturation techniques at 6-months (p > 0.05).

CONCLUSION

CLC, CWC, and TGC root canal obturation techniques were found to have similar efficacy after NSER in a single visit in teeth with AP at six months.

TRIAL REGISTRATION

The research was retrospectively registered on the website www.

CLINICALTRIALS

gov with the registration number NCT06226740 on 26/01/2024.

Post-operative pain after root canal filling with two different obturation techniques: A prospective study

Background

Post-operative pain (POP) is a major problem in endodontics. This prospective study aims to investigate POP and the rate of analgesic intake after root canal treatment (RCT) using two obturation techniques: warm vertical compaction with epoxy resin-based sealer (WVT) versus sealer-based obturation (SBO) using a single-cone gutta-percha with calcium silicate-based sealer.

Material and Methods

All RCT were carried out by the same endodontist, following a standardized protocol, and using two different obturation techniques: WVT with AH Plus sealer, and SBO with single-cone gutta-percha and AH Plus Bioceramic sealer. Patients finally assessed were 29 in the SBO group and 34 in the WVT group. After RCT, patients completed a 10-cm visual analogue scale (VAS) that ranked the level of pain. Results were analysed statistically using the Chi-square, ANOVA tests and logistic regression analysis.

Results

Sex, age, number of roots, pulp diagnosis, periapical status, previous intake of NSAIDs or antibiotics did not affected POP. In the WVT group, 38.2% of patients felt some pain 24 hours post-treatment, while in the SBO group this percentage was 20.7% (p = 0.07). There were no significant differences in the need for analgesics in the week following treatment.

Conclusions

The obturation technique used did not affect significantly the POP of patients after RCT. Although the percentage of patients in the SOB group showing POP was lower, there were no significant differences in the need to take analgesics. Key words:Calcium silicate sealer, endodontic pain, post-operative pain, resin based sealer, sealer based obturation, single cone obturation, warm vertical compaction.

Post-operative pain in non-surgical root canal treatment after sealer-based obturation versus warm vertical compaction: A randomized clinical trial

AIM

Post-operative pain may occur after non-surgical root canal treatment (NSRCT). The root filling technique and choice of sealer may be contributing factors. This randomized controlled clinical trial compared post-operative pain and analgesics intake after NSRCT using a sealer-based obturation technique (SBO) with single-cone gutta-percha and calcium silicate sealer (CSS) versus a warm-vertical compaction (WVC) technique with gutta-percha and a resin-based sealer (RBS).

METHODOLOGY

This study was designed as a parallel-two arm, double-blind, randomized superiority clinical trial registered at www.

CLINICALTRIALS

gov (NCT04753138). Patients referred for NSRCT fulfilling the inclusion criteria participated in this study. Pre-operative periapical radiographs and CBCT scans were taken and numerical rating scale (NRS) pain scores were recorded. Upon completion of canal instrumentation, participants were randomly allocated to either Group SBO: SBO with CSS or Group WVC: Warm-vertical compaction with RBS. Post-operative pain and analgesics intake were recorded at 1, 3 and 7 days after endodontic treatment completion. Non-parametric Mann-Whitney U and Friedman tests and a generalized estimating equation were used to assess differences in pain scores between the groups, within each treatment group at different time points and for correlations, respectively.

RESULTS

The study included 195 participants (212 teeth). One participant declined to submit the NRS form. Therefore, 194 participants (211 teeth) were included in the final analysis (99.5% response rate). No statistically significant differences in post-operative pain or analgesic intake existed between the two groups at any time point (p > .05). Age, pre-operative pain, apical diagnosis and post-operative analgesic intake were significantly related to post-operative pain (p < .05).

CONCLUSIONS

Sealer-based obturation technique with CSS was associated with similar post-operative pain levels and analgesics intake as WVC with RBS. Regarding post-operative pain, SBO with CSSs may be a suitable clinical alternative.