Main Article Content
Objective: All root canal preparation techniques can potentially result in debris protruding apically, leading to postoperative pain. This study aimed to assess the effects of different file systems on postoperative pain in root canal treatments performed on primary molar teeth.
Material and Methods: The study included 100 patients aged 5-8 years. NiTi K-type hand files (NTK), rotary file systems ProTaper Next (PTN), AF Baby (AFB), EndoArt Niti Pedo Gold (EAN), and reciprocal file system WaveOne Gold (WOG) were employed in the canal treatment of mandibular primary molars. Postoperative pain was assessed using the Visual Analog Scale (VAS) at the 6th, 12th, 18th, 24th, 48th, 72nd hour, and 1st week following treatment, and the collected data were evaluated statistically.
Results: When considering time as a factor, the postoperative pain values among the groups were compared using the Kruskal-Wallis H test, and no statistically significant differences were observed (p = 0.007). In numerical terms, the group using NTK, EAN, AFB, and PTN exhibited the highest average postoperative pain, while the group using WOG, a reciprocal system, had the lowest pain.
Conclusion: In conclusion, the choice of file used impacts postoperative pain. There was no statistically significant difference in time-independent postoperative pain values between rotary files designed for primary teeth and those intended for permanent teeth. However, using files specifically designed for primary teeth is recommended, considering factors such as working comfort and suitability for working length.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Kratunova E, Silva D. Pulp therapy for primary and immature permanent teeth: an overview. Gen Dent. 2018;66(6):30-48.
Guelzow A, Stamm O, Martus P, Kielbassa AM. Comparative study of six Rotary nickel-titanium systems and hand instrumentation for root canal preparation. Int Endod J. 2005;38(10):743-752. DOI: https://doi.org/10.1111/j.1365-2591.2005.01010.x
Barr ES, Kleier DJ, Barr NV. Use of nickel-titanium rotary files for root canal preparation in primary teeth. Pediatr Dent. 2000;22:77-78.
Crespo S, Cortes O, Garcia C, Perez L. Comparison between rotary and manual instrumentation in primary teeth. J Clin Pediatr Dent. 2008;32(4):295-298. DOI: https://doi.org/10.17796/jcpd.32.4.l57l36355u606576
Panchal V, Jeevanandan G, Subramanian EMG. Comparison of post-operative pain after root canal instrumentation with hand K-files, H-files and rotary Kedo-S files in primary teeth: a randomised clinical trial. Eur Arch Paediatr Dent. 2019;20(5):467–472. DOI: https://doi.org/10.1007/s40368-019-00429-5
Nekoofar MH, Sadeghipanah M, Dehpour AR. Evaluation of meloxicam (A cox-2 inhibitor) for management of postoperative endodontic pain: a double-blind placebo-controlled study. J Endod. 2003;29(10):634–647. DOI: https://doi.org/10.1097/00004770-200310000-00005
Genet JM, Hart AA, Wesselink PR, Thoden van Velzen SK. Preoperative and operative factors associated with pain after the first endodontic visit. Int Endod J. 1987;20(2):53–64. DOI: https://doi.org/10.1111/j.1365-2591.1987.tb00590.x
Perković I, Romić MK, Perić M, Krmek SJ. The level of anxiety and pain perception of endodontic patients. Acta Stomatol Croat. 2014;48(4):258–267. DOI: https://doi.org/10.15644/asc48/4/3
Burklein S, Schafer E. Apically extruded debris with reciprocating single-file and full-sequence rotary instrumentation systems. J Endod. 2012;38(6),850-852. DOI: https://doi.org/10.1016/j.joen.2012.02.017
Elheeny AAH, Abdelmotelb MA. Postoperative pain after primary molar pulpectomy using rotary or reciprocating single files: A superior, parallel, randomized clinical trial. Int J Paediatr Dent. 2022;32(6):819-827. DOI: https://doi.org/10.1111/ipd.12959
Jeevanandan G, Ravindran V, Subramanian EM, Kumar AS. Postoperative pain with hand, reciprocating, and rotary instrumentation techniques after root canal preparation in primary molars: A randomized clinical trial. Int J Clin Pediatr Dent. 2020;13(1):21-26. DOI: https://doi.org/10.5005/jp-journals-10005-1709
Nair M, Jeevanandan G, Vignesh R, Subramanian EMG. Comparative evaluation of post-operative pain after pulpectomy with k-files, kedo-s files and mtwo files in deciduous molars -a randomized clinical trial. Braz Dent Sci. 2018;21(4):411–417. DOI: https://doi.org/10.14295/bds.2018.v21i4.1617
Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32(2):271-275. DOI: https://doi.org/10.1016/0030-4220(71)90230-1
Topçuoğlu G, Topçuoğlu HS, Delikan E, Aydınbelge M, Doğan S. Postoperative pain after root canal preparation with hand and rotary files in primary molar teeth. Pediatr Dent. 2017;39(3):192–196.
Alnassar I, Altinawi M, Rekab MS, Katbeh I, Khasan A, Almokaddam H. Pain assessment following endodontic treatment using two automated systems compared to manual treatment in primary molars. Dent Med Probl. 2021;58(3):305-310. DOI: https://doi.org/10.17219/dmp/130083
Iranmanesh F, Parirokh M, Haghdoost AA, Abbott PV. Effect of corticosteroids on pain relief following root canal treatment: A systematic review. Iran Endod J. 2017;12(2):123-130.
Alves Vde O. Endodontic flare-ups: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110(5):68-72. DOI: https://doi.org/10.1016/j.tripleo.2010.05.014
Topçuoğlu G. Evaluation of apically extruded debris during canal shaping with a pedodontic rotary file used with reciprocating motion in primary teeth. Selcuk Dent J, 2022; 9: 870-874. DOI: https://doi.org/10.15311/selcukdentj.1191781
Lakshmanan L, Ganesh Jeevanandan. Comparison of post-operative pain after pulpectomy using kedo-s square file, hand h file and k file - A randomized controlled trial. Int J Dentistry Oral Sci. 2021;8(4):2272-2276. DOI: https://doi.org/10.19070/2377-8075-21000449
Girish Babu KL, Kavyashree G. Determination of correlation between the quality of obturation and postoperative pain following root canal preparation with rotary and manual file systems in the primary molars-A comparative randomized clinical trial. Pediatric Dental Journal. 2022;32(1):16-25. DOI: https://doi.org/10.1016/j.pdj.2021.12.001
Çapar ID, Arslan H, Akçay M, Ertaş H. An in vitro comparison of apically extruded debris and instrumentation times with ProTaper Universal, ProTaper Next, Twisted File Adaptive, and HyFlex instruments. J Endod. 2014;40(10):1638-1641. DOI: https://doi.org/10.1016/j.joen.2014.04.004
Hulsmann M, Peters OA, Dummer PM. Mechanical preparation of root canals: Shaping goals, techniques and means. Endod Top. 2005;10(1):30-76. DOI: https://doi.org/10.1111/j.1601-1546.2005.00152.x