Evaluation of the Impact of Different Instrumentation Techniques on the Incidence of Postoperative Pain in Patients Undergoing Root Canal Treatment

Abstract

Background: Postoperative pain is a common concern in root canal treatment, and the choice of instrumentation technique can significantly impact patient comfort. This study aimed to evaluate the impact of different instrumentation techniques on the incidence of postoperative pain in patients undergoing root canal treatment.Methods: A randomized controlled trial was conducted on 208 patients randomly assigned to four groups: step-back preparation, crown-down preparation, hybrid technique, and conventional instrumentation. Pain intensity was assessed using a verbal rating scale (VRS) at six, 12, 24, 48, and 72 hours postoperatively. Data were analyzed using appropriate statistical methods.Results: The mean pain scores and standard deviations (SDs) were calculated for each instrumentation technique at different time intervals. At six hours, the step-back preparation group reported a mean pain score of 2.3 (SD = 0.8), the crown-down preparation group had a score of 2.8 (SD = 0.9), the hybrid technique group had a score of 2.5 (SD = 0.7), and the conventional instrumentation group had a score of 3.1 (SD = 0.1). The differences in pain scores between the groups were statistically significant at all time intervals (p < 0.05). Conclusion:The choice of instrumentation technique significantly influenced the incidence of postoperative pain in root canal treatment. The step-back preparation technique was associated with lower pain intensity than the crown-down preparation, hybrid technique, and conventional instrumentation. These findings highlight the importance of considering the instrumentation technique to optimize patient comfort during and after root canal treatment.

Evaluating In Vitro Performance of a Novel Stainless Steel Rotary System (Gentlefile) Based on Debris Extrusion and Instrumentation Time

“…The evaluation of the GF system was conducted in response to claims that this stainless steel system offers advantages over traditional nickel-titanium files. Additionally, a recent randomized controlled trial discovered that patients reported a reduction in pain intensity when the manual step-back approach was utilized, as compared to other commonly employed techniques such as crown-down, hybrid, and conventional instrumentation [ 15 ]. The aforementioned observation implies that the utilization of the step-back technique could potentially lead to a reduction in the extrusion of debris.…”

“…The step-back technique enlarges the canal in a graduated manner by using sequentially larger files. A recent randomized controlled trial found that patients experienced less intense pain with the manual step-back approach versus other common techniques such as crown-down, hybrid, and conventional instrumentation [ 15 ]. This suggests that the step-back technique may result in less debris extrusion.…”

To Evaluate Different Endodontic Instrumentation Systems Regarding Post-Operative Pain After Endodontic Therapy: A Clinical Study

“…However, varying root canal instrumentation systems appear to be linked to varying degrees of extrusion [13][14][15][16]. Some research reveals higher levels of extruded contaminants following the use of hand endodontic files instead of engine-driven endodontic files [17][18][19][20][21].…”