Search Results (6)

The evidence for photobiomodulation in reducing postoperative pain after endodontic instrumentation is classified as low or very low certainty, indicating a need for further research. Longitudinal pain assessments over 24 h are crucial, and studies should explore these pain periods. Background/Objectives: This double-blind, randomized controlled clinical trial evaluated the effect of PBM on pain following single-visit endodontic treatment of maxillary molars at 4, 8, 12, and 24 h. Primary outcomes included pain at 24 h; secondary outcomes included pain at 4, 8, and 12 h, pain during palpation/percussion, OHIP-14 analysis, and frequencies of pain. Methods: Approved by the Research Ethics Committee (5.598.290) and registered in Clinical Trials (NCT06253767), the study recruited adults (21–70 years) requiring endodontic treatment in maxillary molars. Fifty-eight molars were randomly assigned to two groups: the PBM Group (n = 29), receiving conventional endodontic treatment with PBM (100 mW, 333 mW/cm², 9 J distributed at 3 points near root apices), and the control group (n = 29), receiving conventional treatment with PBM simulation. Pain was assessed using the Visual Analog Scale. Results: Statistical analyses used chi-square and Mann–Whitney tests, with explained variance (η²). Ten participants were excluded, leaving 48 patients for analysis. No significant differences were observed in postoperative pain at 24, 4, 8, or 12 h, or in palpation/percussion or OHIP-14 scores. Pain frequencies ranged from 12.5% to 25%. Conclusions: PBM does not influence post-treatment pain in maxillary molars under these conditions. These results emphasize the importance of relying on well-designed clinical trials to guide treatment decisions, and future research should focus on personalized dosimetry adapted to the anatomical characteristics of the treated dental region to enhance the accuracy and efficacy of therapeutic protocols. Full article

The need for controlling bacteria and pain during root canal therapy is undeniable. This clinical trial aimed to assess whether there is a difference in colony-forming unit (CFU) reduction after instrumentation and post-endodontic pain after root canal treatment (RCT) using a traditional endodontic cavity (TEC) versus a conservative endodontic cavity (CEC). This clinical study was conducted on 89 patients designated for a single-visit RCT. Patients were allocated randomly (TEC n = 45 and CEC n = 44). The access opening was gained accordingly in each group by a single operator. A pre-instrumentation sample of root canal dentin was collected using an endodontic file; the second sample was collected similarly, right after shaping and cleaning the root canal. The CFU was calculated based on the samples collected. The pain level was recorded preoperatively and at 1, 7, and 21 days postoperatively utilizing a visual analog scale (VAS). There were no statistically significant differences in the CFU reduction between the TEC and CEC groups (p > 0.05). Additionally, there were no statistically significant differences found in postoperative pain levels between the TEC and CEC at 1, 7, and 21 days (p > 0.05). Despite the limitations of this study, both the CEC and TEC demonstrate a decrease in bacteria within the root canals and alleviate postoperative pain with no difference between them. Full article

Root canal treatment (RCT) eliminates damaged pulpal tissue and protects the tooth from recurrent microbial invasion. Post-endodontic pain (PEP) is a frequently encountered complication of root canal therapy. It can have an impact on patients’ quality of life (QoL) and their subjective perception of treatment options. Thus, a self-assessment questionnaire was used to evaluate and compare the influence of manual, rotary, and reciprocating file shaping procedures on immediate post-operative quality of life (POQoL) involving single-visit root canal therapy. It was a double-blinded, randomized, controlled clinical trial. A total of 120 participants were randomly assigned sequentially to three groups comprising 40 patients in each group: Group A: Hand K file (positive control); Group B: ProTaper Next file system; and Group C: WaveOne Gold. Post-operative pain was evaluated using a 4-point visual analog scale (VAS) after 12 h, 24 h, 48 h, 72 h, and 1 week. The highest post-operative pain was with manual instrumentation using hand K files, and the lowest was with reciprocating and rotating instrumentations. No significant difference was noted between the parameters of quality of life assessed, suggesting the filing system or technique had a similar effect. Full article

The study presents results of periapical lesion healing after one-visit root canal treatment (RCT) with Advanced Platelet Rich Fibrin plus (A-PRF+) application compared to a two-visit RCT with an inter-appointment calcium hydroxide filling. The comparison was made based on CBCT-Periapical Index (PAI) lesion volume changes and the occurrence of post endodontic pain. The results of 3D radiographic healing assessments based on volume reduction criteria were different from the CBCT-PAI. Based on volume changes, the healing assessment criteria-9 cases from the Study Group and six cases in the Control Group were defined as healed. Based on the CBCT-PAI healing assessment criteria, 8 cases from the Study Group and 9 cases from the Control Group were categorized as healed. The volumes of apical radiolucency were, on average, reduced by 85.93% in the Study Group and by 72.31% in the Control Group. Post-endodontic pain occurred more frequently in the Control than in the Study Group. The highest score of pain in the Study Group was five (moderate pain, n = 1), while in the Control Group, the highest score was eight (severe pain, n = 2). In the 6-month follow-up, CBCT scans showed a better healing tendency for patients in the Study Group. Full article

To assess the incidence and intensity of postendodontic pain and flareup in single and multiple visit root canal treatment (RCT) and determine if the difference between the two is significant, a search of PubMed, Medline, Embase, Cochrane, Scopus and Web of science was conducted. The grey literature was searched using Google Scholar and Saudi digital library. Randomised controlled trials evaluating the incidence and intensity of postendodontic pain and flareup published in English from 1 January 2000 to 15 April 2020 were searched. The PRISMA protocol was followed to select the articles. A random effects model was used for the meta-analysis of the data in the included studies. Twenty-one articles were included in the review. Three compared both the incidence and the intensity, while the rest compared either one of the parameters. Most studies used both hand-driven and rotary instruments and irrigated with sodium hypochlorite. Twelve studies used an intracanal medicament. Although individual studies showed discordant treatment outcomes, the meta-analysis did not reveal any significant difference in the incidence or the intensity of the postendodontic flareup between the single and multiple visit RCT groups. Single or a multiple visit root canal treatment is not an independent determinant for the risk of postendodontic pain or a flareup. Full article

The objective of this prospective study was to assess tooth-related factors that play a role in the incidence of postoperative pain (PP) and determining if procedural errors influence PP occurrence. A total of 442 patients referred for root canal treatment met the inclusion criteria and were included in this prospective study. The same protocol was used in all root canal treatments. Patient, tooth, treatment related factors and the occurrence of procedural errors were registered. Incidence and intensity of PP was assessed at 24 and 48 h by telephonic interview and in person seven and 15 days after treatment. A logistic and ordinal regression analysis was used to assess the role of patient, tooth and treatment related factors in the incidence and intensity of PP, respectively. Preoperative and intraoperative factors differently affected the incidence of PP at the different time intervals. The presence of procedural errors did not significantly influence PP occurrence. The presence of preoperative pain and the need of additional anesthesia during treatment were associated with higher incidence of PP 24 and 48 h after treatment; the extent of apical enlargement played a significant role in the presence of PP after seven days of treatment; and the excessive occlusal load induced by the absence of a contralateral tooth was the only factor related to the maintenance of PP up to 15 days. In conclusion, the presence of preoperative pain, the need of additional anesthesia during treatment, the extent of apical enlargement and the excessive occlusal load induced by the absence of a contralateral tooth were related to a higher incidence of PP. Full article