Postoperative Pain After Endodontic Treatment

This clinical study is designed to evaluate the effects of different irrigation agitation techniques and root canal sealers on postoperative pain and oral health-related quality of life in patients with symptomatic irreversible pulpitis. Postoperative pain following root canal treatment may affect patient comfort and satisfaction. The choice of irrigation agitation technique and root canal sealer may influence these outcomes. Irrigation agitation techniques are used to improve cleaning of the root canal system. XP-Endo Finisher, EDDY, and passive ultrasonic activation use different mechanisms to enhance this process. Root canal sealers, including the epoxy resin-based AH Plus and the calcium silicate-based NeoSealer Flo, also differ in their composition and biological properties. Clinical evidence regarding the combined effects of these techniques and sealers on patient-reported outcomes remains limited. In this randomized clinical trial, 324 patients aged 18-65 years requiring root canal treatment for a single-rooted, single-canal permanent tooth with symptomatic irreversible pulpitis will be allocated to six groups. Each group will receive one of three irrigation agitation techniques-XP-Endo Finisher, EDDY, or passive ultrasonic activation-in combination with either AH Plus or NeoSealer Flo. Root canal treatment will be completed in a single visit. Postoperative pain intensity will be assessed using a visual analog scale at 6, 12, 24, 48, and 72 hours and 7 days after treatment. Oral health-related quality of life will be assessed using the Oral Health Impact Profile-14 questionnaire before treatment and 7 days afterward. Analgesic use during the follow-up period will also be recorded. The primary objective is to compare postoperative pain among the six treatment groups. Secondary objectives include evaluating changes in oral health-related quality of life and analgesic consumption. The study will also investigate whether irrigation agitation techniques and root canal sealers have interacting effects on postoperative pain. The findings may help clinicians select irrigation agitation techniques and root canal sealers that support patient comfort and improve the patient experience following root canal treatment.

Brief Summary This prospective, randomized clinical trial aims to evaluate the effect of different endodontic motor settings used during root canal treatment on postoperative pain. During root canal treatment, the inner part of the tooth is cleaned and shaped using specialized rotating instruments. These instruments can operate with different motion patterns, and the motor may respond differently as the instrument approaches the tip of the root. The influence of these technical variations on postoperative pain has not been clearly established. Adult participants requiring root canal treatment for mandibular premolar teeth will be enrolled in the study. Participants will be randomly assigned to different groups. In each group, root canal treatment will be performed using different motor motion settings. All procedures applied in this study are routine and safe treatment methods commonly used in clinical endodontic practice. After treatment, participants' pain levels will be monitored through telephone follow-ups. Pain intensity will be assessed using the Visual Analog Scale (VAS). In addition, analgesic intake will be recorded. The purpose of this study is to determine whether different endodontic motor settings influence postoperative pain and patient comfort following root canal treatment. The findings are expected to contribute to safer and more comfortable root canal treatment protocols.

Title Evaluation of the Effect of Reciprocal and Rotational NiTi File Systems and XP-Endo Finisher Combination on Postoperative Pain Clinical Research Protocol Summary Objective The aim of this study is to compare the effects of different NiTi file systems (FKG Race Evo and One Reci) and their combination with XP-Endo Finisher on postoperative pain. The study intends to evaluate how these two different file systems and XP-Endo Finisher influence patients' pain levels after endodontic treatment. It is also hypothesized that XP-Endo Finisher may play an important role in reducing postoperative pain by enhancing irrigation efficacy. This study is expected to contribute clinically significant findings to the limited literature on this topic. Background Endodontic treatment is a procedure performed to mechanically shape, disinfect, and hermetically seal teeth with pulpal damage or periapical lesions caused by caries or trauma. The success of treatment depends on proper shaping within biological limits, effective disinfection, preservation of apical constriction, and removal of bacteria from canal walls. NiTi alloys have improved canal shaping efficiency due to their flexibility and shape memory properties. Rotary and reciprocating NiTi systems each offer different clinical advantages. Rotary systems provide efficient shaping through continuous rotation, while reciprocating systems offer a minimally invasive approach using a single file. Postoperative pain is a common complication after endodontic treatment and may vary depending on instrumentation technique, irrigation protocol, and clinical conditions. Irrigation is essential for removing microorganisms and debris from the canal system. Conventional irrigation techniques may be insufficient to reach apical areas effectively. Therefore, advanced systems such as XP-Endo Finisher have been developed to improve irrigant penetration and enhance cleaning efficiency. FKG Race Evo is a rotary NiTi system with high cyclic fatigue resistance, while One Reci is a reciprocating single-file system that offers safe shaping with reduced procedural errors. This study will evaluate the postoperative pain outcomes of these systems in combination with XP-Endo Finisher. Materials and Methods The materials used in this study include FKG Race Evo and One Reci NiTi file systems, XP-Endo Finisher, 2.5% sodium hypochlorite (NaOCl), 17% EDTA, and saline solution. The study will be conducted on 80 patients attending the Department of Endodontics, Faculty of Dentistry, Eskisehir Osmangazi University. Healthy individuals aged 18-65 years with chronic apical periodontitis or periapical radiolucent lesions will be included. Written informed consent will be obtained from all participants. Patients will be randomly divided into four groups: Group 1: Instrumentation with FKG Race Evo 25/06 Group 2: FKG Race Evo 25/06 followed by XP-Endo Finisher irrigation Group 3: Instrumentation with One Reci 25/06 Group 4: One Reci 25/06 followed by XP-Endo Finisher irrigation All procedures will be performed under rubber dam isolation and local anesthesia. Canal shaping will be performed according to the assigned system, with irrigation performed after each file change. Obturation will be completed in the second session. Sample Size Calculation The sample size was calculated using G\*Power software (3.1.9.4; Heinrich Heine University, Düsseldorf, Germany). The calculation was based on a 5% type I error (alpha), 95% power (1-β), and an effect size of 0.587 (f), derived from a previous study. A total of 80 participants was determined to be sufficient to detect statistically significant differences between groups. Each group will include 20 patients. Statistical Analysis All data will be recorded electronically with strict confidentiality. Only authorized researchers will have access to the dataset. Statistical analysis will be performed using appropriate software. The choice of statistical tests will depend on data distribution. Study results may be published in national or international peer-reviewed journals in accordance with ethical and legal requirements. All data will be anonymized to protect participant confidentiality, and secure electronic storage will be used to prevent unauthorized access.

A short description of the clinical study, including a brief statement of the clinical study's hypothesis, written in language intended for the lay public.