Effect of two different concentrations of sodium hypochlorite on postoperative pain following single‐visit root canal treatment: a triple‐blind randomized clinical trial

Abstract

Farzaneh S, Parirokh M, Nakhaee N, Abbott PV. Aim To compare the effects of two different concentrations of NaOCl solution on postoperative pain following single-visit root canal treatment in mandibular molars with irreversible pulpitis. Methodology A total of 122 patients who had mandibular molars with irreversible pulpitis were treated. The patients were randomly divided into two groups according to the concentration of NaOCl used during root canal instrumentation -either 2.5% or 5.25%. RaCe rotary instruments were used for root canal preparation, and all root canals were filled in one visit. Postoperative pain was evaluated using the visual analogue scale. Data were analysed by independent t-test, chi-square and Mann-Whitney tests. Results Twelve patients were excluded for various reasons. Pain reported by 110 patients who were eligible to be included in the study was analysed. No significant differences were found in the age and gender of the patients between the two groups (P = 0.50, P = 0.51, respectively). The patients who had 5.25% NaOCl reported significantly lower postoperative pain compared to those who had 2.5% NaOCl during the first 72 h following treatment (P = 0.021); however, there was no significant difference in pain felt by the patients during the rest of the study period, that is 4-7 days following treatment (P = 0.185) when the four-level pain categorization method was used. When the two-level pain categorization method was used, the results revealed that patients who had 5.25% NaOCl reported significantly less pain for the first 3 days after treatment (P = 0.026). The number of analgesics taken by patients who had 2.5% NaOCl was significantly higher than that taken by patients who had 5.25% NaOCl (P = 0.001). Conclusion 5.25% NaOCl was associated with significantly lower postoperative pain compared to 2.5% NaOCl during the first 72 h following one-visit root canal treatment of mandibular molars with irreversible pulpitis.

Evaluation of the effects of the solution used for electrochemical dissolution of nickel–titanium endodontic files on dentine structure, microhardness and cell viability

“…), 0.5–5.25% NaOCl solutions have been described for use in clinical practice (Baumgartner & Cuenin , Farzaneh et al . ), demonstrating significantly lower postoperative pain than other solutions (Farzaneh et al . ).…”

“…), demonstrating significantly lower postoperative pain than other solutions (Farzaneh et al . ). It is important to highlight that cultured cells are considerably more sensitive to toxicity induced by chemical agents than periapical tissues (Bajrami et al .…”

“…NaOCl has excellent properties as an effective irrigant, such as the ability to dissolve organic components and necrotic tissues and eliminate microorganisms present in biofilms (Zehnder 2006). Despite the toxic effect on eukaryotic cells, even at low concentrations (Lineaweaver et al 1985, Sura et al 2001, 0.5-5.25% NaOCl solutions have been described for use in clinical practice (Baumgartner & Cuenin 1992, Farzaneh et al 2018, demonstrating significantly lower postoperative pain than other solutions (Farzaneh et al 2018). It is important to highlight that cultured cells are considerably more sensitive to toxicity induced by chemical agents than periapical tissues (Bajrami et al 2014).…”

“…Amaral et al Electrochemical dissolution solutions effects on dentine International Endodontic Journal, 51, 1434-1445, 2018 the root could protrude from the tube. A rubber O-ring (Ø 0.5 cm) was inserted into the upper end of each plastic microtube, as previously described (De-Deus et al 2009) and presented in Fig.…”

Influence of different irrigants on substance P and IL‐8 expression for single visit root canal treatment in acute irreversible pulpitis

“…In a study by Farzeneh et al . 2018, using two different concentrations of sodium hypochlorite as irrigants for single visit root canal treatment in mandibular molar teeth with irreversible pulpitis and no history of spontaneous pain, it was shown that the post‐operative pain occurrence was highest during the first 48 h post‐operatively with both concentrations of sodium hypochlorite . However, it was also reported that increased concentration of sodium hypochlorite had significantly less post‐operative pain occurrence .…”