Post-Obturation Pain After Non-Surgical Endodontic Treatment
Post-Obturation Pain After Non-Surgical Endodontic Treatment
Patients commonly complain of post-obturation discomfort and pain after endodontic (root canal) treatments, which can upset both clinicians and patients. The pain intensity can range from mild to severe, and it is widely described as occurring in flare-ups. The duration of the pain can range from one day to several weeks and can be a major cause of patient dissatisfaction. In addition, post-obturation pain after endodontic treatment is a poor indicator of pathosis and an even more unreliable predictor of long-term success. The reported findings on post-obturation pain differ between studies. A systematic review found that it occurs in around 4 to 10 % of patients, in general. However, DiRenzo and colleagues reported in their review that the incidence of post-obturation pain after non-surgical endodontic treatment can be greater than 50 %.
Endodontic treatment once necessitated multiple visits, as it required a considerable amount of time to complete. Multiple-visit root canal treatment is accepted as a safe and common therapy. However, the rationale for multiple-visit endodontic treatment is being questioned. A systematic review found no significant differences between the antimicrobial efficacies reported for single-visit and multiple-visit treatments. In addition, the use of contemporary endodontic techniques and equipment, such as magnifying devices, electronic apex locators, and engine-driven rotary nickel titanium files, not only increases the success rate of endodontic treatment but also shortens the time needed for treatment.
Cold lateral condensation (CLC) using gutta-percha is a commonly taught method of obturation. Dental practitioners use it often, and it frequently serves as a basis of comparison for new obturation techniques. The core carrier obturation technique has become popular since its introduction in late 1980s, as studies have generally found that it as effective as CLC for root canal obturation. In addition, many clinicians consider it to be fast, predictable, easy to use, effective, and useful for small, curved, or densely packed canals. The Thermafil (TF) obturator (Dentsply Maillefer, Ballaigues, Switzerland) is a typical product used in core carrier obturation. Gencoglu compared the apical sealing of obturation with TF and CLC and found that TF was better than CLC. Studies have also suggested that core carrier obturation is more effective than CLC at filling lateral canals. Furthermore, TF was shown to have less leakage than CLC.
If the incidence and intensity of post-obturation pain and the long-term success rate for single-visit and multiple-visit endodontic treatments are similar, single-visit treatment can be considered to be the more comfortable and efficient option. The aim of this study was to compare the incidence of post-obturation pain at one and seven days after single-visit and multiple-visit primary non-surgical endodontic treatments. The primary outcome measured was the incidence of post-obturation pain. The secondary outcome measured was the intensity of post-obturation pain. The first hypothesis is that there is no difference in the incidence of post-obturation pain for single-visit and multiple-visit non-surgical endodontic therapies one day after obturation; the second hypothesis is that there is no difference in the incidence of post-obturation pain for single-visit and multiple-visit non-surgical endodontic therapies seven days after obturation.
Background
Patients commonly complain of post-obturation discomfort and pain after endodontic (root canal) treatments, which can upset both clinicians and patients. The pain intensity can range from mild to severe, and it is widely described as occurring in flare-ups. The duration of the pain can range from one day to several weeks and can be a major cause of patient dissatisfaction. In addition, post-obturation pain after endodontic treatment is a poor indicator of pathosis and an even more unreliable predictor of long-term success. The reported findings on post-obturation pain differ between studies. A systematic review found that it occurs in around 4 to 10 % of patients, in general. However, DiRenzo and colleagues reported in their review that the incidence of post-obturation pain after non-surgical endodontic treatment can be greater than 50 %.
Endodontic treatment once necessitated multiple visits, as it required a considerable amount of time to complete. Multiple-visit root canal treatment is accepted as a safe and common therapy. However, the rationale for multiple-visit endodontic treatment is being questioned. A systematic review found no significant differences between the antimicrobial efficacies reported for single-visit and multiple-visit treatments. In addition, the use of contemporary endodontic techniques and equipment, such as magnifying devices, electronic apex locators, and engine-driven rotary nickel titanium files, not only increases the success rate of endodontic treatment but also shortens the time needed for treatment.
Cold lateral condensation (CLC) using gutta-percha is a commonly taught method of obturation. Dental practitioners use it often, and it frequently serves as a basis of comparison for new obturation techniques. The core carrier obturation technique has become popular since its introduction in late 1980s, as studies have generally found that it as effective as CLC for root canal obturation. In addition, many clinicians consider it to be fast, predictable, easy to use, effective, and useful for small, curved, or densely packed canals. The Thermafil (TF) obturator (Dentsply Maillefer, Ballaigues, Switzerland) is a typical product used in core carrier obturation. Gencoglu compared the apical sealing of obturation with TF and CLC and found that TF was better than CLC. Studies have also suggested that core carrier obturation is more effective than CLC at filling lateral canals. Furthermore, TF was shown to have less leakage than CLC.
If the incidence and intensity of post-obturation pain and the long-term success rate for single-visit and multiple-visit endodontic treatments are similar, single-visit treatment can be considered to be the more comfortable and efficient option. The aim of this study was to compare the incidence of post-obturation pain at one and seven days after single-visit and multiple-visit primary non-surgical endodontic treatments. The primary outcome measured was the incidence of post-obturation pain. The secondary outcome measured was the intensity of post-obturation pain. The first hypothesis is that there is no difference in the incidence of post-obturation pain for single-visit and multiple-visit non-surgical endodontic therapies one day after obturation; the second hypothesis is that there is no difference in the incidence of post-obturation pain for single-visit and multiple-visit non-surgical endodontic therapies seven days after obturation.
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