Evaluation of postoperative pain after endodontic treatment with foraminal enlargement and obturation using two auxiliary chemical protocols

Abstract

Aim This prospective randomized clinical study examined the influence of two different auxiliary chemical substances on postoperative pain in 301 single-visit endodontic treatments, with enlargement of the apical foramen and extrusion of cement into the periapical region. Material and method The two auxiliary chemicals used were 2% chlorhexidine (2% CHX gel; n = 145) and 5.25% sodium hypochlorite (5.25% NaOCl; n = 156). The incidence of postoperative pain and discomfort was assessed at 24 hours and expressed as percentages. The Fisher exact test and the Chi-square test were used to compare variation in postoperative pain. The variables analyzed were previous pain, pulp status, age, and number of root canals. Result In teeth with previous pain instrumented with 2% CHX gel, the incidence of postoperative pain was 22.22% (6/27) versus 11.11% (3/22) in teeth instrumented with 5.25% NaOCl. In teeth without previous pain instrumented with 2% CHX gel, the incidence of postoperative pain was 8.5% (6/118) versus 2.33% (3/129) in teeth instrumented with 5.25% NaOCl, with no statistically significant difference between the groups. Results showed that previous pain had a significant influence on postoperative status (p < 0.001). After 24 hours postoperatively, 93.7% (282/301) of the teeth had no pain and 6.3% (19/301) had some level of pain, and used one or two doses of medication. Conclusion Based on the results, it can be concluded that the auxiliary chemical substances had no influence on postoperative pain.

Predictors, prevention, and management of postoperative pain associated with nonsurgical root canal treatment: A systematic review

“…The results of this systematic review revealed that the incidence of postoperative pain during the first 24–48 hours ranges from 3 to 69.3% 1, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19. Mild to moderate pain has been observed in some studies,1, 12, 13, 17, 18, 19, 20, 21 and moderate to severe pain has been observed in other studies 1, 8, 11, 22.…”

The influence of sodium hypochlorite and chlorhexidine on postoperative pain in necrotic teeth: a systematic review

“…The overall quality of the studies and the data provided by the included studies demonstrated that the risk of bias was considered “low risk” in two studies ( 25 , 26 ), and the other three studies were considered to have a “high risk” of bias ( 27 - 29 ) ( Fig. 2 ).…”

“…Data analysis showed that 4 studies had a low risk of bias in the random sequence generation ( 25 , 26 , 28 , 29 ). Two studies did not report concealment of allocation ( 27 , 29 ), and only one study reported blinding of participants and personnel ( 25 ).…”

“…Data analysis showed that 4 studies had a low risk of bias in the random sequence generation ( 25 , 26 , 28 , 29 ). Two studies did not report concealment of allocation ( 27 , 29 ), and only one study reported blinding of participants and personnel ( 25 ). There was a low risk of bias in all studies regarding the reporting of incomplete outcome data; selective reporting; and inclusion and exclusion criteria, however, only one of them described how the sample calculation was performed ( 26 ), 3 beings ( 27 - 29 ) evaluated with a high risk of bias and only one rated as unclear ( 25 ).…”

Assessment of Postoperative Pain Using Different Root Canal Irrigants in Mandibular Molars with Symptomatic Irreversible Pulpitis: An Observational Study

“…Reddy et al 13 in their study compared formocresol with the NaOCl solution in primary molars and found NaOCl a good agent. Bourreau ML et al 14 in their study found that in teeth with previous pain instrumented with the 2% CHX gel, the incidence of postoperative pain was 22.22% (6/27) versus 11.11% (3/22) in teeth instrumented with 5.25% NaOCl. Authors concluded that the auxiliary chemical substances had no influence on postoperative pain.…”