Incidence of post obturation pain related to two root canal hand preparation techniques: a prospective clinical study

ABSTRACT

This prospective study was undertaken to determine the incidence of post obturation pain related to root canal treatment of asymptomatic non-vital maxillary central incisor teeth that were prepared and filled in one visit using two different manual root canal preparation techniques the step-back and the step-down and to determine the relationship, if any between post obturation pain and root canal preparation technique. The incidence of post obturation pain was recorded and evaluated over an observation period of one week in 120 patients. Five patients were excluded from the analysis as they failed to attend for post obturation evaluation. Of the remaining 115 patients who returned for evaluation after 2 days following the obturation of the root canal system, 94 patients had no pain, 10 had slight pain, 9 patients had moderate pain and 2 patients had pain of severe nature for maxillary central incisor teeth instrumented and filled in one appointment. Clinical evaluation performed 7 days following the obturation of the root canal systems revealed that 3 patients had pain of moderate nature and were from the same group of patients who reported pain at the 2 days post obturation period. The incidence of post obturation pain of moderate and severe nature in a symptomatic endodontically treated non vital maxillary central incisor teeth was 9.5% after 2 days and 2.6% after 7 days following obturation. The percentage of patients experiencing moderate to severe pain after 2 days following obturation was 10.6% for the step back patients group and 8.6% for the step down patients group. At the 7 days post obturation period 3.5% of patients experiencing moderate to severe pain in the step back groups compared to 1.7% in the step down patients group. No statistically significant difference in the incidence and degree of post obturation pain was found between patients who had teeth treated endodontically using the step-down manual root canal preparation technique