In-Vivo Assessment Of The Efficacy For Rotary To Manual Instrumentation With Ultrasonic Irrigation On Intensity, Duration, And Incidence Of Post Endodontic Pain: A Comparative Study

Abstract

Background: Successful endodontic treatment is governed by reduced/ minimal post-endodontic pain. However, varying pain has been reported following endodontic treatment and is attributed to various factors including instrumentation and shaping techniques. 

Aim: The present study aimed to comparatively assess the efficacy of rotary to manual instrumentation with ultrasonic irrigation on intensity, duration, and incidence of post-endodontic pain.

Methods: 160 subjects undergoing single-sitting root canals in maxillary anterior teeth secondary to irreversible pulpitis were assessed in the present study. 160 subjects were randomly allocated to 2 groups of 80 subjects each where Group I subjects were treated with the step-back technique and k-files and Group II with the crown-down technique and ProTaper Next with ultrasonic irrigation. A questionnaire for post-endodontic pain was filled by subjects at 24 hours, 48 hours, and 7 days to assess the intensity, duration, and incidence of post-endodontic pain.

Results: The study results showed that the incidence of post-endodontic pain was significantly higher in Group I where manual instrumentation was done with k files compared to rotary instrumentation (Group II) with a p-value of 0.001. A similar significant difference was seen in the 2 groups at different time intervals.

Conclusion: The study concludes that post-endodontic pain is associated with both manual and rotary instrumentation techniques. However, more pain incidence is seen in the manual instrumentation compared to the rotary instrumentation technique. Also, a higher duration of pain was seen in the manual instrumentation group at different assessment times.