When to install the endodontic post? First visit with root canal filling versus a separate second visit for post‐restoration: A randomized controlled trial

Abstract

Background The vibrations created by post‐space preparation during the first visit for endodontic treatment could have a significant effect on the intensity of post‐operative pain than that association with post‐space preparation at the second appointment. Objective The aim of this study was to evaluate the effect of vibrations generated during post‐installation, on post‐operative pain in endodontically treated teeth. Methods One hundred patients with asymptomatic teeth requiring primary root canal treatment and post‐installation were enrolled in this study. Fifty patients underwent endodontic treatment with post‐installation at the first visit (group 1), while the remaining 50 patients underwent post‐installation at the second visit (group 2). The intensity of post‐operative pain in both groups was evaluated 1, 2, 3 days and 1 week after the first visit using the visual analogue scale. The time required to achieve complete pain relief for each patient was also recorded. The patients' age, sex, tooth type, size of the periapical lesion and time required for complete post‐operative pain relief for each tooth were recorded. Results The pain intensity score was significantly higher in group 1 than group 2 (P < .05). No significant differences were observed in parameters such as sex, tooth type, jaw and size of the periapical lesion (P > .05), whereas age had a significant effect on the post‐operative pain scores (P < .05). Conclusion Vibrations occurring during post‐installation on the same visit as that of root canal filling may increase the post‐operative pain.

Immediate and Delayed Post Space Preparations in Endodontically Treated Teeth: A Scoping Review

“…An electronic pain rating scale program with a vertical visual analog scale (VAS) was used after the first visit for both groups to evaluate post-operative pain by an RCT (Table 7 ) [ 11 ]. Results presented no post-operative pain in patients with delayed post cementation, in contrast, there was significantly higher post-operative pain in immediate post installation on days 1, 2 and 3 and 1 week after the first visit.…”

“…A randomized controlled trial evaluated the post-operative pain of PSP and showed the vibrations generated during post-installation by a low-speed handpiece with dedicated fiber post drills from the post kit in the same visit of root canal filling might increase the post-operative pain. Therefore, the cumulative effect of root canal treatment and post installation in the first visit might increase the intensity of pain [ 11 ]. Although delayed PSP was recommended, more studies are necessary to thoroughly investigate the effects of the timing of PSP on post-operative pain.…”

“…However there are disagreements regarding the time interval between the root canal filling and the PSP [ 7 ]. The time of PSP may influence some outcomes in endodontically treated teeth such as void formation [ 10 ], displacement of filling material [ 9 ], the bond strength of the post [ 5 ], and post-operative pain [ 11 ]. Nevertheless, there are no consensus on the post-operative pain induced by post-endodontic restorations after single- or two-visit root canal treatments [ 11 ].…”

Reliability of Clinical Examination Methods for Pain in Periapical Periodontitis

“…Various factors play important roles in endodontic pain, such as host-dependent, chemical, or mechanical injury, or bacterial infection [2]. In particular, apical extrusion of infected debris and mechanical vibration and/or noise created by different handpieces during root canal instrumentation have also been shown to affect postoperative pain [3][4][5]. Several studies have investigated the effect of procedural methodology on postoperative pain, such as the number of visits [6], endodontic les with different kinematics [7,8], and irrigation [9] or lling protocols [10], proving that these factors affect postoperative pain.…”

“…However, there are con icting results among these studies that may be associated with the subjectivity of the data on postoperative pain [7,11]. It has been recognized that during data collection in the studies mentioned above, some studies demand the presence of patients in the clinic for all follow-up periods [4,7], whereas others simply schedule a telephonic conversation with patients for pain intensity evaluations [8,9].…”