Postoperative pain intensity after using different instrumentation techniques: a randomized clinical study

Abstract Postoperative pain is a frequent complication associated with root canal treatment, especially during apical instrumentation of tooth with preexisting periradicular inflammation Objectives The aim of this clinical study was to evaluate the influence of the instrumentation techniques on the incidence and intensity of postoperative pain in single-visit root canal treatment. Material and Methods Ninety patients with single root/canal and non-vital pulps were included. The patients were assigned into 3 groups according to root canal instrumentation technique used; modified step-back, reciprocal, and rotational techniques. Root canal treatment was carried out in a single visit and the severity of postoperative pain was assessed via 4-point pain intensity scale. All the participants were called through the phone at 12, 24 and 48 h to obtain the pain scores. Data were analyzed through the Kruskal–Wallis test. Results There was significant difference between all groups (p<0.05). The modified step-back technique produced postoperative pain significantly lower than the rotational (p=0.018) and reciprocal (p=0.020) techniques. No difference was found between the reciprocal and rotational techniques (p=0.868). Postoperative pain in the first 12 h period (p=0.763) and in the 24 h period (p=0.147) was not significantly different between the groups. However, the difference in the 48 h period was statistically different between the groups (p=0.040). Conclusion All instrumentation techniques caused postoperative pain. The modified step-back technique produced less pain compared to the rotational and reciprocal techniques.

Age and sex-related differences of pulp chamber size in mandibular second molars.

Aim: The aim of this study was to compare the size of the pulp chamber in mandibular second molars with the gender and age by means of panoramic radiographs. Materials and Methods: In this study, 200 panoramic radiographs of patients were randomly selected from the archives of the Faculty of Dentistry of Ondokuz Mayis University. The radiographs of the patients were measured under a stereomicroscope and categorized according to the gender and age. Results: Statistically differences were found in the mean sizes of pulp chamber between the groups under and above the age of 30 years (P < 0.05). There were significant differences in terms of “the distance between the tip of the lingual cusp to the roof of the pulp chamber”, “the distance between the tip of the lingual cusp to the floor of the pulp chamber” and “the distance from the tip of the lingual cusp to the closest point of the furcation” between the male and female genders (P < 0.05). Conclusion: It is concluded that the pulp chamber can be exposed easily in female patients, because it is less shallow than males. However, the size of pulp chamber reduces after the age of 30 years in both the genders.