Postoperative pain after endodontic reintervention: a randomized clinical trial

• Published in: Brazilian dental journal Vol. 33; no. 3; pp. 18 - 27
• Main Authors: Spohr, Andressa Raquel, Xavier, Samantha Rodrigues, Malta, Cristiana Pereira, Pereira-Cenci, Tatiana, Pappen, Fernanda Geraldo, Morgental, Renata Dornelles
• Format: Journal Article
• Language: English
• Published: Fundação Odontológica de Ribeirão Preto 24-06-2022
• ISSN: 0103-6440; 1806-4760
• DOI: 10.1590/0103-6440202204785

The present randomized clinical trial compared the prevalence and intensity of
postoperative pain in cases of endodontic reintervention using manual or
engine-driven reciprocating instruments. As secondary objectives, the analgesic
intake and time required for the root canal filling removal and
re-instrumentation were also evaluated. Forty-eight individuals with an
endodontically treated single-rooted tooth diagnosed with asymptomatic apical
periodontitis were included in the study. Patients were randomly assigned to two
comparison groups (n=24/group): reintervention with stainless steel manual
instruments or a nickel-titanium reciprocating system (Reciproc; VDW, Munich,
Germany). The endodontic reintervention was performed in two sessions with a
calcium hydroxide-based intracanal medication applied for 14 days before root
canal obturation. Working time for the root canal filling removal and
re-instrumentation was recorded with a digital stopwatch. After each visit,
postoperative pain intensity was assessed at 12, 24, and 48 hours and seven days
using the Numerical Rating Scale (NRS). The patients were also asked about
analgesic intake. Data were analyzed using Pearson chi-square, T and
Mann-Whitney U tests (α=0.05). No significant differences between groups were
found regarding the prevalence and intensity of pain or the need for analgesic
intake at any time point (P > 0.05). Working time was significantly shorter
in the reciprocating group (18 versus 41 minutes). In conclusion, manual and
reciprocating instruments achieved the same results in terms of prevalence and
intensity of postoperative pain and analgesic intake. However, filling material
removal and re-instrumentation of the root canals were more than twice as fast
when using the reciprocating system.