The aim of this study was to evaluate pain perception, pain medication intake, and sealer extrusion after single-visit root canal treatment of asymptomatic teeth with or without foraminal enlargement. The correlation between sealer extrusion and pain was also investigated.
One hundred forty necrotic, single-rooted teeth were divided into 2 groups (n = 70): foraminal patency (FP), in which treatment was performed up to 1 mm short of the apex, and foraminal enlargement (FE), in which treatment was performed up to the apex. The canals were instrumented using WaveOne Gold files (Dentsply Maillefer, Ballaigues, Switzerland), irrigated with 2.5% sodium hypochlorite, and filled using the single-cone technique and AH Plus sealer (Dentsply Maillefer). A visual analog scale was used to record pain 24, 48, and 72 hours and 1 week postoperatively. The presence or absence of sealer extrusion was recorded.
Pain levels were significantly higher for FE than FP at 24 hours (P < .05), namely 0.3 ± 0.9 versus 0.1 ± 0.1; no difference was found at 48 hours, namely 0.1 ± 0.5 versus 0.0 ± 0.0 (P > .05). No pain was reported 72 hours or 1 week postoperatively in either group. Although all patients requiring pain medication at 24 hours were from the FE group, the difference between FE and FP was not statistically significant with respect to this variable (P > .05). Nevertheless, the intake amount was significantly higher in FE than in FP at this time point (P < .05). Sealer extrusion occurred more frequently in FE than FP, namely 57.14 % versus 14.29% (P < .05). There was no association between pain and sealer extrusion (P > .05) or between pain and sex, age, or tooth type (P > .05).
FE was related to higher pain levels 24 hours postoperatively and to higher rates of filling material extrusion; however, there was no association between filling material extrusion and postoperative pain.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Endodontics
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Predictive models of pain following root canal treatment: a prospective clinical study.Int Endod J. 2013; 46: 784-793
- Rocas IN, Favieri A, et al. Incidence of postoperative pain after intracanal procedures based on an antimicrobial strategy.J Endod. 2002; 28: 457-460
- Comparison of the incidence of postoperative pain after using 2 reciprocating systems and a continuous rotary system: a prospective randomized clinical trial.J Endod. 2016; 42: 171-176
- Comparison of the effect of root canal preparation by using WaveOne and ProTaper on postoperative pain: a randomized clinical trial.J Endod. 2015; 41: 575-578
- Canal preparation using only one Ni-Ti rotary instrument: preliminary observations.Int Endod J. 2008; 41: 339-344
- Microtomography-based comparison of reciprocating single-file F2 ProTaper technique versus rotary full sequence.J Endod. 2011; 37: 1394-1397
- Assessment of apically extruded debris produced by the single-file ProTaper F2 technique under reciprocating movement.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110: 390-394
- Apical extrusion of bacteria when using reciprocating single-file and rotary multifile instrumentation systems.Int Endod J. 2014; 47: 560-566
- Surface nanoscale profile of WaveOne, WaveOne Gold, Reciproc, and Reciproc blue, before and after root canal preparation.Odontology. 2019; 107: 500-506
- Participation of bacterial biofilms in refractory and chronic periapical periodontitis.J Endod. 2002; 28: 679-683
- Apical limit of root canal instrumentation and obturation, part 2. A histological study.Int Endod J. 1998; 31: 394-409
- Biofilms and apical periodontitis: study of prevalence and association with clinical and histopathologic findings.J Endod. 2010; 36: 1277-1288
- Influence of foraminal enlargement on the healing of periapical lesions in rat molars.Clin Oral Investig. 2019; 23: 1985-1991
- Influence of apical enlargement on the repair of apical periodontitis in rats.Int Endod J. 2018; 51: 1261-1270
- Influence of apical foramen widening and sealer on the healing of chronic periapical lesions induced in dogs' teeth.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109: 932-940
- Influence of the enlargement of the apical foramen in periapical repair of contaminated teeth of dog.Oral Surg Oral Med Oral Pathol. 1987; 64: 480-484
- Foraminal deformation after foraminal enlargement with rotary and reciprocating kinematics: a scanning electronic microscopy study.J Endod. 2018; 44: 145-148
- Does maintaining apical patency during instrumentation increase postoperative pain or flare-up rate after nonsurgical root canal treatment? A systematic review of randomized controlled trials.J Endod. 2018; 44: 1228-1236
- Assessment of extrusion and postoperative pain of a bioceramic and resin-based root canal sealer.Eur J Dent. 2019; 13: 343-348
- The effects of photodynamic therapy on postoperative pain in teeth with necrotic pulps.Photodiagnosis Photodyn Ther. 2019; 27: 396-401
- Endodontic flare-ups: a prospective study.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110: e68-e72
- Endodontic interappointment flare-ups: a prospective study of incidence and related factors.J Endod. 1992; 18: 172-177
- Relationship between postendodontic pain, tooth diagnostic factors, and apical patency.J Endod. 2009; 35: 189-192
- Maintaining apical patency does not increase postoperative pain in molars with necrotic pulp and apical periodontitis: a randomized controlled trial.J Endod. 2018; 44: 335-340
- Pain following foraminal enlargement in mandibular molars with necrosis and apical periodontitis: a randomized controlled trial.Int Endod J. 2016; 49: 1116-1123
- The effect of foraminal enlargement of necrotic teeth with a continuous rotary system on postoperative pain: a randomized controlled trial.J Endod. 2017; 43: 359-363
- Postoperative pain after foraminal enlargement in anterior teeth with necrosis and apical periodontitis: a prospective and randomized clinical trial.J Endod. 2013; 39: 173-176
- Apical extrusion of debris and irrigants using two hand and three engine-driven instrumentation techniques.Int Endod J. 2001; 34: 354-358
- The effect of foraminal enlargement of necrotic teeth with the Reciproc system on postoperative pain: a prospective and randomized clinical trial.J Endod. 2016; 42: 8-11
- Clinical outcome of non-surgical root canal treatment using a single-cone technique with EndoSequence bioceramic sealer: a retrospective analysis.J Endod. 2018; 44: 941-945
- In vitro interrelationship between apical fill and apical leakage using three different obturation techniques.J Int Soc Prev Community Dent. 2018; 8: 503-507
- Outcome of root canal obturation by warm gutta-percha versus cold lateral condensation: a meta-analysis.J Endod. 2007; 33: 106-109
- Factors associated with postoperative pain in endodontic therapy.Int J Biomed Sci. 2014; 10: 243-247
Published online: April 18, 2021
© 2021 American Association of Endodontists.