Influence of maintaining apical patency in post-endodontic pain

Abstract

BackgroundThe concept of instrumentation beyond the apical foramen by small flexible file to prevent apical blockage is apical patency. However, this procedure might endow postoperative pain, thus to maintain apical patency or not is the matter of dilemma. Hence, the primary objective of this study was to compare postoperative pain between apical patency and non-patency groups and secondary objective was to evaluate the influence of number of visits, vitality of teeth, group of teeth and preoperative pain on post-operative pain.MethodsOne hundred sixty patients were included in the study. Patients were randomly divided into: Group A (n = 80) contained apical patency maintained and Group B (n = 80) contained those treated without apical patency. Each group was subdivided into equal number of patients treated in single visit (n = 40) and multiple visits (n = 40), including vital (n=20) and non-vital teeth (n=20) and single- rooted (n=10) and multiple-rooted teeth (n=10). Apical patency was maintained with a size 10 K-file during conventional hand filing step-back shaping procedure. Intensity of pain was recorded before treatment and on days 1, 2, and 7 after treatment using a Numerical Rating Scale (NRS-11). Statistical analysis was done using Mann -Whitney U test, Spearman correlation and Multiple linear regression analysis.ResultsThe primary outcome of this study showed statistically significant difference (p<0.05) in postoperative pain scores between patency and non-patency groups with higher pain scores in patency group on 1st, 2nd and 7th day follow up. The secondary outcome showed postoperative pain in patency maintained group was influenced by status of the pulp and preoperative pain only. Vital teeth of patency-maintained group treated in multiple visits showed statistically significant (p=0.02) post-operative pain in day 1 follow up. Pre-operative pain showed positive correlation with postoperative pain with statistically significant difference.ConclusionsOur study concluded that maintenance of apical patency increased postoperative pain. Evaluation of influence of number of visits, status of pulp, group of tooth and preoperative pain revealed status of pulp and preoperative pain as influencing factors for postoperative pain in patency group.

Comparative Phytochemical Profiling of Garlics (Allium sativum L.) and Onion (Alium cepa L.)

“…The content of sugar also decreases if the thermal processing period was further increased (28). Onion sample also showed green precipitate in both extracts that indicates a low amount of reducing sugars; less than 0.5g% (36), in the sample. In the study conducted by Badessa et al (38), quantitative phytochemical screening of the ethanolic extract of onion bulbs (Allium cepa) showed a significant amount of carbohydrates in the onion samples.…”

“…Benedict's tests showed the presence of reducing sugar in all samples, except for WG in ethyl acetate extract. The colour changed to brick red precipitate in the BG ethanolic extract and this indicates there was a high amount of reducing sugars in the sample with more than 2.0 g% sugar concentration (36). As for ethyl acetate extract, the colour was greenish yellow precipitate which indicates a small amount of reducing sugars detected in the BG sample due to the low polarity of the solvent.…”