CC BY-NC-ND 4.0 · Eur J Dent 2020; 14(02): 274-280
DOI: 10.1055/s-0040-1709930
Original Article

In Vivo Evaluation of Painful Symptomatology after Endodontic Treatment Performed Using Two Different Irrigation Needle Insertion Depths

Sarah Gutierrez Tavares
1   Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
,
Carlos Eduardo Fontana
2   Department of Endodontics, School of Dentistry, Pontifical Catholic University of Campinas, Campinas, São Paulo, Brazil
,
Alexandre Sigrist De Martin
1   Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
,
Sérgio Luiz Pinheiro
2   Department of Endodontics, School of Dentistry, Pontifical Catholic University of Campinas, Campinas, São Paulo, Brazil
,
Rina Andrea Pelegrine
1   Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
,
Daniel Guimarães Pedro Rocha
2   Department of Endodontics, School of Dentistry, Pontifical Catholic University of Campinas, Campinas, São Paulo, Brazil
› Author Affiliations

Abstract

Objective The main purpose of this study was to evaluate pain symptoms in patients after endodontic treatment performed in a single session in teeth with vitality or pulp necrosis, comparing two depths of insertion of the NaviTip irrigation needle.

Materials and Methods One-hundred upper uniradicular teeth were selected and divided into four groups (n = 25), namely Bio group 1 (live pulp/1 mm from the foramen), Bio group 3 (live pulp/3 mm from the foramen), Necro group 1 (pulp necrosis/1 mm from the foramen), and Necro group 3 (pulp necrosis/3 mm from the foramen). All canals were instrumented with Wave One Gold System. Irrigation was performed using 2.5% NaOCl. The teeth were filled using the single-cone technique with AH Plus sealer using a McSpadden compactor. After treatment, patients answered a questionnaire with a visual analog scale scored from 0 to 10 at 1, 3, and 7 days after treatment.

Statistical Analysis Data were analyzed using Mann–Whitney U, Wilcoxon, and Friedman tests.

Results There was a decrease in average pain levels at the three time points for both vital and necrotic teeth (p < 0.05). There were no significant differences in postoperative pain levels comparing needle depth, or vitality and pulp necrosis (p > 0.05). The percentage of mild pain increased over time and moderate pain decreased, regardless of pulp condition. There was no incidence of acute pain at any time.

Conclusions Post-treatment endodontic pain levels in upper uniradicular teeth with or without pulp vitality resulted in similar pain scores, regardless of the depth of insertion of the irrigation needle in relation to the apical foramen.



Publication History

Article published online:
12 May 2020

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Thieme Medical and Scientific Publishers Private Ltd.
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  • References

  • 1 Pochapski MT, Santos FA, de Andrade ED, Sydney GB. Effect of pretreatment dexamethasone on postendodontic pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108 (05) 790-795
  • 2 Ince B, Ercan E, Dalli M, Dulgergil CT, Zorba YO, Colak H. Incidence of postoperative pain after single- and multi-visit endodontic treatment in teeth with vital and non-vital pulp. Eur J Dent 2009; 3 (04) 273-279
  • 3 Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review. Int Endod J 2008; 41 (02) 91-99
  • 4 Alves VdeO. Endodontic flare-ups: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110 (05) e68-e72
  • 5 Seltzer S. Pain in endodontics. 1986. J Endod 2004; 30 (07) 501-503
  • 6 Gulabivala K, Patel B, Evans G, Ng YL. Effects of mechanical and chemical procedures on root canal surfaces. Endod Topics 2005; 10: 103-122
  • 7 Gutmann JL. Clinical, radiographic, and histologic perspectives on success and failure in endodontics. Dent Clin North Am 1992; 36 (02) 379-392
  • 8 Siqueira Jr JF. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J 2001; 34 (01) 1-10
  • 9 Dioguardi M, Gioia GD, Illuzzi G, Laneve E, Cocco A, Troiano G. Endodontic irrigants: different methods to improve efficacy and related problems. Eur J Dent 2018; 12 (03) 459-466
  • 10 Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod 2004; 30 (08) 559-567
  • 11 Goldman M, Kronman JH, Goldman LB, Clausen H, Grady J. New method of irrigation during endodontic treatment. J Endod 1976; 2 (09) 257-260
  • 12 Kahn FH, Rosenberg PA, Gliksberg J. An in vitro evaluation of the irrigating characteristics of ultrasonic and subsonic handpieces and irrigating needles and probes. J Endod 1995; 21 (05) 277-280
  • 13 Vinothkumar TS, Kavitha S, Lakshminarayanan L, Gomathi NS, Kumar V. Influence of irrigating needle-tip designs in removing bacteria inoculated into instrumented root canals measured using single-tube luminometer. J Endod 2007; 33 (06) 746-748
  • 14 Chow TW. Mechanical effectiveness of root canal irrigation. J Endod 1983; 9 (11) 475-479
  • 15 Abou-Rass M, Piccinino MV. The effectiveness of four clinical irrigation methods on the removal of root canal debris. Oral Surg Oral Med Oral Pathol 1982; 54 (03) 323-328
  • 16 Albrecht LJ, Baumgartner JC, Marshall JG. Evaluation of apical debris removal using various sizes and tapers of ProFile GT files. J Endod 2004; 30 (06) 425-428
  • 17 Vaudt J, Bitter K, Neumann K, Kielbassa AM. Ex vivo study on root canal instrumentation of two rotary nickel-titanium systems in comparison to stainless steel hand instruments. Int Endod J 2009; 42 (01) 22-33
  • 18 Madhusudhana K, Mathew VB, Reddy NM. Apical extrusion of debris and irrigants using hand and three rotary instrumentation systems - an in vitro study. Contemp Clin Dent 2010; 1 (04) 234-236
  • 19 Yared G. Canal preparation using only one Ni-Ti rotary instrument: preliminary observations. Int Endod J 2008; 41 (04) 339-344
  • 20 Gutmann JL, Fava LR. Periradicular healing and apical closure of a non-vital tooth in the presence of bacterial contamination. Int Endod J 1992; 25 (06) 307-311
  • 21 Boutsioukis C, Psimma Z, Kastrinakis E. The effect of flow rate and agitation technique on irrigant extrusion ex vivo. Int Endod J 2014; 47 (05) 487-496
  • 22 Mitchell RP, Baumgartner JC, Sedgley CM. Apical extrusion of sodium hypochlorite using different root canal irrigation systems. J Endod 2011; 37 (12) 1677-1681
  • 23 Yaylali IE, Kurnaz S, Tunca YM. Maintaining apical patency does not increase postoperative pain in molars with necrotic pulp and apical periodontitis: a randomized controlled trial. J Endod 2018; 44 (03) 335-340
  • 24 Tinoco JM, De-Deus G, Tinoco EM, Saavedra F, Fidel RA, Sassone LM. Apical extrusion of bacteria when using reciprocating single-file and rotary multifile instrumentation systems. Int Endod J 2014; 47 (06) 560-566
  • 25 Koçak S, Koçak MM, Sağlam BC, Türker SA, Sağsen B, Er Ö. Apical extrusion of debris using self-adjusting file, reciprocating single-file, and 2 rotary instrumentation systems. J Endod 2013; 39 (10) 1278-1280
  • 26 De-Deus G, Brandão MC, Barino B, Di Giorgi K, Fidel RA, Luna AS. Assessment of apically extruded debris produced by the single-file ProTaper F2 technique under reciprocating movement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110 (03) 390-394
  • 27 Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J 2011; 44 (07) 583-609
  • 28 Pedullà E, Grande NM, Plotino G, Gambarini G, Rapisarda E. Influence of continuous or reciprocating motion on cyclic fatigue resistance of 4 different nickel-titanium rotary instruments. J Endod 2013; 39 (02) 258-261
  • 29 Gavini G, Caldeira CL, Akisue E, Candeiro GT, Kawakami DA. Resistance to flexural fatigue of Reciproc R25 files under continuous rotation and reciprocating movement. J Endod 2012; 38 (05) 684-687
  • 30 Roane JB, Sabala C. Clockwise or counterclockwise. J Endod 1984; 10 (08) 349-353
  • 31 Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LW. Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. J Endod 2010; 36 (05) 875-879
  • 32 Shen Y, Gao Y, Qian W. et al. Three-dimensional numeric simulation of root canal irrigant flow with different irrigation needles. J Endod 2010; 36 (05) 884-889
  • 33 Hülsmann M, Hahn W. Complications during root canal irrigation–literature review and case reports. Int Endod J 2000; 33 (03) 186-193
  • 34 Desai P, Himel V. Comparative safety of various intracanal irrigation systems. J Endod 2009; 35 (04) 545-549
  • 35 Boutsioukis C, Lambrianidis T, Verhaagen B. et al. The effect of needle-insertion depth on the irrigant flow in the root canal: evaluation using an unsteady computational fluid dynamics model. J Endod 2010; 36 (10) 1664-1668
  • 36 Sedgley CM, Nagel AC, Hall D, Applegate B. Influence of irrigant needle depth in removing bioluminescent bacteria inoculated into instrumented root canals using real-time imaging in vitro. Int Endod J 2005; 38 (02) 97-104
  • 37 Hsieh YD, Gau CH, Kung SF Wu, Shen EC, Hsu PW, Fu E. Dynamic recording of irrigating fluid distribution in root canals using thermal image analysis. Int Endod J 2007; 40 (01) 11-17
  • 38 Tambe VH, Nagmode PS, Vishwas JR, P. SK, Angadi P, Ali FM. Evaluation of the amount of debris extruded apically by using conventional syringe, Endovac and ultrasonic irrigation technique: an in vitro study. J Int Oral Health 2013; 5 (03) 63-66
  • 39 Ramamoorthi S, Nivedhitha MS, Divyanand MJ. Comparative evaluation of postoperative pain after using endodontic needle and EndoActivator during root canal irrigation: a randomised controlled trial. Aust Endod J 2015; 41 (02) 78-87