ABSTRACT
The main objectives of this study were to determine the incidence and degree of interappointment pain associated with the use of various irrigants and medicaments utilized during endodontic treatment and to determine, through statistical analysis, if a significant relationship existsed between such pain and various conditions of the treated teeth. This prospective clinical study was composed of 318 patients who presented for endodontic treatment in the department of Dentistry at Prince Rashid Ben Al Hassan Hospital between 1991-1994. Patients age ranged from 14-67years; 177were males and 141 were females. The patients were randomly allocated to three groups to which the chemical agents to be used for irrigation and intracanal medication were assigned. Formolcresol was used in the treatment of patients in group 1, non-setting calcium hydroxide paste in group 2, while patients in group 3 received no intracanal medicament [control group]. Sodium hypochlorite solution [2.6%] was used as an irrigant in both group 1 and group 2 patients, while physiologic normal saline solution was used in group 3 patients. Instrumentation of the root canals was completed at the first visit. All endodontically treated root canals were filled by lateral condensation of gutta-percha with Seal Apex root canal sealer. The incidence and degree of pain experienced by the patients during the course of root canal therapy were assessed. Of the 318 patients evaluated, 244 [76.7%] had no interappointment pain, 52 [16.4%] had slight pain, and 22 [6.9%] had moderate to severe pain. There was no significant difference in the incidence and degree of interappointment pain between patient groups or between any of the groups in respect to teeth which had initially been vital, non - vital, intactor opened previously for pain and teeth with and without periapical radiolucent areas. In vital teeth, the incidence of interappointment pain was 35.5% in group 1patients, 20% in group 2 and 23.3% in group 3 patients. Regarding non-vital teeth, the incidence of interappointment pain was 29.5% in group 1 whereas in group 2 and 3 it was 14.7% and 20.9% respectively. The clinical use of either formolcresol or non-setting calcium hydroxide paste as an intracanal medicament in conjunction with the irrigant sodium hypochlorite [2.6%] solution for treatment of maxillary central incisors does not cause an increased incidence or degree of interappointment pain compared with normal saline solution irrigant without an intracanal medicament. In patients beginning endodontic treatment in those teeth with no symptoms, the occurrence of interappointment pain is not clinically predictable