Effect of Different Obturation Techniques on Postoperative Pain

Overview

This study evaluated the postoperative pain after the endodontic treatment by using three different obturation techniques. ( Cold lateral condensation (CLC), thermoplasticized solid-core carrier method (GuttaCore) and cold free-flow compation tecnique ( GuttaFlow2))

Full Title of Study: “Comparison of Postoperative Pain Intensity After Three Different Obturation Techniques: A Randomized Clinical Trial”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Other
    • Masking: Single (Participant)
  • Study Primary Completion Date: March 4, 2019

Interventions

  • Other: Root Canal Obturation Technique
    • This study aims to compare the effects of three different obturation techniques(cold lateral condensation,thermoplasticized solid-core carrier method, cold free flow compaction technique) on postoperative pain following the endodontic therapy

Arms, Groups and Cohorts

  • Other: Ah plus
    • The root canals obturated with Ah plus root canal sealer (Dentsply, Sirona) and gutta-percha cones with cold lateral condensation technique.
  • Other: ROEKO GuttaFlow® 2
    • The root canals obturated with GuttaFlow 2 root canal sealer (Coltene,Whaledent) and single tapered gutta-percha cone with cold free flow compaction technique.
  • Other: GuttaCore Obturators
    • The root canals obturated with GuttaCore obturators (Dentsply,Sirona) and Ah plus root canal sealer with thermoplasticized solid-core carrier technique

Clinical Trial Outcome Measures

Primary Measures

  • Pain level comparison after root canal obturation with three different obturation technique:: VAS (Visual Analogue Scale) at 6th hours.
    • Time Frame: 6th hours.
    • Based on the VAS (Visual Analogue Scale), the pain levels of the patients were assessed. The scale consisted of a 100-mm-long line divided into 10 equal intervals from 0 (no pain) to 100 (very severe pain). Every patient was asked to mark his or her perceived postoperative pain level on the line.
  • Pain level comparison after root canal obturation with three different obturation technique.: VAS (Visual Analogue Scale) at 12th hours.
    • Time Frame: 12th hours.
    • ased on the VAS (Visual Analogue Scale), the pain levels of the patients were assessed. The scale consisted of a 100-mm-long line divided into 10 equal intervals from 0 (no pain) to 100 (very severe pain). Every patient was asked to mark his or her perceived postoperative pain level on the line.
  • Pain level comparison after root canal obturation with three different obturation technique.: VAS (Visual Analogue Scale) at 24th hours
    • Time Frame: 24th hours.
    • Based on the VAS (Visual Analogue Scale), the pain levels of the patients were assessed. The scale consisted of a 100-mm-long line divided into 10 equal intervals from 0 (no pain) to 100 (very severe pain). Every patient was asked to mark his or her perceived postoperative pain level on the line.
  • Pain level comparison after root canal obturation with three different obturation technique.: VAS (Visual Analogue Scale) at 2nd days.
    • Time Frame: 2nd days
    • Based on the VAS (Visual Analogue Scale), the pain levels of the patients were assessed. The scale consisted of a 100-mm-long line divided into 10 equal intervals from 0 (no pain) to 100 (very severe pain). Every patient was asked to mark his or her perceived postoperative pain level on the line.
  • Pain level comparison after root canal obturation with three different obturation technique.: VAS (Visual Analogue Scale) at 3th days.
    • Time Frame: 3th days
    • Based on the VAS (Visual Analogue Scale), the pain levels of the patients were assessed. The scale consisted of a 100-mm-long line divided into 10 equal intervals from 0 (no pain) to 100 (very severe pain). Every patient was asked to mark his or her perceived postoperative pain level on the line.
  • Pain level comparison after root canal obturation with three different obturation technique.: VAS (Visual Analogue Scale) at 4th days.
    • Time Frame: 4th days.
    • Based on the VAS (Visual Analogue Scale), the pain levels of the patients were assessed. The scale consisted of a 100-mm-long line divided into 10 equal intervals from 0 (no pain) to 100 (very severe pain). Every patient was asked to mark his or her perceived postoperative pain level on the line.
  • Pain level comparison after root canal obturation with three different obturation technique.: VAS (Visual Analogue Scale) at 5th days.
    • Time Frame: 5th days
    • Based on the VAS (Visual Analogue Scale), the pain levels of the patients were assessed. The scale consisted of a 100-mm-long line divided into 10 equal intervals from 0 (no pain) to 100 (very severe pain). Every patient was asked to mark his or her perceived postoperative pain level on the line.
  • Pain level comparison after root canal obturation with three different obturation technique.: VAS (Visual Analogue Scale) at 6th days.
    • Time Frame: 6th days
    • Based on the VAS (Visual Analogue Scale), the pain levels of the patients were assessed. The scale consisted of a 100-mm-long line divided into 10 equal intervals from 0 (no pain) to 100 (very severe pain). Every patient was asked to mark his or her perceived postoperative pain level on the line.
  • Pain level comparison after root canal obturation with three different obturation technique.: VAS (Visual Analogue Scale) at 7th days.
    • Time Frame: 7th days
    • Based on the VAS (Visual Analogue Scale), the pain levels of the patients were assessed. The scale consisted of a 100-mm-long line divided into 10 equal intervals from 0 (no pain) to 100 (very severe pain). Every patient was asked to mark his or her perceived postoperative pain level on the line.

Secondary Measures

  • Analgesic intake comparison after root canal obturation with three different obturation technique at 6th hours
    • Time Frame: 6th hours.
    • The patients were asked to choose one of the three options: “0: No pain, or no pain which does not require the use of analgesics”, “1: Moderate pain which can be controlled very well by the use of analgesics and does not affect daily activities or sleep”, “2: Daily activities Unbearable pain that cannot be controlled by the use of analgesics”
  • Analgesic intake comparison after root canal obturation with three different obturation technique at 12th hours
    • Time Frame: 12th hours
    • The patients were asked to choose one of the three options: “0: No pain, or no pain which does not require the use of analgesics”, “1: Moderate pain which can be controlled very well by the use of analgesics and does not affect daily activities or sleep”, “2: Daily activities Unbearable pain that cannot be controlled by the use of analgesics”
  • Analgesic intake comparison after root canal obturation with three different obturation technique at 24th hours
    • Time Frame: 24th hours.
    • The patients were asked to choose one of the three options: “0: No pain, or no pain which does not require the use of analgesics”, “1: Moderate pain which can be controlled very well by the use of analgesics and does not affect daily activities or sleep”, “2: Daily activities Unbearable pain that cannot be controlled by the use of analgesics”
  • Analgesic intake comparison after root canal obturation with three different obturation technique at 2nd days
    • Time Frame: 2nd days
    • The patients were asked to choose one of the three options: “0: No pain, or no pain which does not require the use of analgesics”, “1: Moderate pain which can be controlled very well by the use of analgesics and does not affect daily activities or sleep”, “2: Daily activities Unbearable pain that cannot be controlled by the use of analgesics”
  • Analgesic intake comparison after root canal obturation with three different obturation technique at 3th days
    • Time Frame: 3th days
    • The patients were asked to choose one of the three options: “0: No pain, or no pain which does not require the use of analgesics”, “1: Moderate pain which can be controlled very well by the use of analgesics and does not affect daily activities or sleep”, “2: Daily activities Unbearable pain that cannot be controlled by the use of analgesics”
  • Analgesic intake comparison after root canal obturation with three different obturation technique at 4th days
    • Time Frame: 4 th days
    • The patients were asked to choose one of the three options: “0: No pain, or no pain which does not require the use of analgesics”, “1: Moderate pain which can be controlled very well by the use of analgesics and does not affect daily activities or sleep”, “2: Daily activities Unbearable pain that cannot be controlled by the use of analgesics”
  • Analgesic intake comparison after root canal obturation with three different obturation technique at 5th days
    • Time Frame: 5th days
    • The patients were asked to choose one of the three options: “0: No pain, or no pain which does not require the use of analgesics”, “1: Moderate pain which can be controlled very well by the use of analgesics and does not affect daily activities or sleep”, “2: Daily activities Unbearable pain that cannot be controlled by the use of analgesics”
  • Analgesic intake comparison after root canal obturation with three different obturation technique at 6th days
    • Time Frame: 6th days
    • The patients were asked to choose one of the three options: “0: No pain, or no pain which does not require the use of analgesics”, “1: Moderate pain which can be controlled very well by the use of analgesics and does not affect daily activities or sleep”, “2: Daily activities Unbearable pain that cannot be controlled by the use of analgesics”
  • Analgesic intake comparison after root canal obturation with three different obturation technique at 7th days
    • Time Frame: 7th days.
    • The patients were asked to choose one of the three options: “0: No pain, or no pain which does not require the use of analgesics”, “1: Moderate pain which can be controlled very well by the use of analgesics and does not affect daily activities or sleep”, “2: Daily activities Unbearable pain that cannot be controlled by the use of analgesics”

Participating in This Clinical Trial

Inclusion Criteria

1. Participants between 18 – 72 years of ages,

2 Good oral hygiene,

3. Have not taken any analgesic in the last 7 days,

4. Have not taken any antibiotics in the last 7 days,

5. Positive response to both cold test (EndoIce; Coltene/Whaledent Inc, Cuyahoga ),

6. Patients diagnosed with asymptomatic irreversible pulpitis with his/her single-rooted teeth caused by a deep carious lesion,

7. Patients have single-rooted teeth requiring endodontic treatment according to the pre-prosthetic reason,

8.The presence of profusely pulp bleeding with a thick consistency, which is exposed during caries removing.

9. The periapical region was healthy in radiographic diagnosis.

Exclusion Criteria

1. Patients who refuse to participate in this study,

2. Medically compromised patients (with immunosuppressive/systemic diseases, patients on medications),

3. Devital teeth that have no response to pulp test,

4. The presence of advanced periodontal disease (probing depth > 4 mm),

5. The presence of open apex,

6. The presence of calcification,

7. The presence of resorption,

8. Patients who had multiple teeth requiring endodontic treatment,

9. Patients with allergic sensitivity to materials and agents that should be used during the root canal treatment,

10. Allergic sensitivity to local anesthetics,

11. Patients who had systemic or allergic sensitivity for the NSAIDs,

12. Pregnant participants or participants in the lactation period,

13. Teeth cannot be applied to a rubber-dam.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 72 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Aydin Adnan Menderes University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Hicran Dönmez Özkan, Assistant Professor – Aydin Adnan Menderes University
  • Overall Official(s)
    • Hicran Dönmez Özkan, Study Director, Adnan Menderes University, Faculty of Dentistry

References

Alonso-Ezpeleta LO, Gasco-Garcia C, Castellanos-Cosano L, Martín-González J, López-Frías FJ, Segura-Egea JJ. Postoperative pain after one-visit root-canal treatment on teeth with vital pulps: comparison of three different obturation techniques. Med Oral Patol Oral Cir Bucal. 2012 Jul 1;17(4):e721-7.

Su Y, Wang C, Ye L. Healing rate and post-obturation pain of single- versus multiple-visit endodontic treatment for infected root canals: a systematic review. J Endod. 2011 Feb;37(2):125-32. doi: 10.1016/j.joen.2010.09.005. Epub 2010 Nov 12. Review.

Citations Reporting on Results

Graunaite I, Skucaite N, Lodiene G, Agentiene I, Machiulskiene V. Effect of Resin-based and Bioceramic Root Canal Sealers on Postoperative Pain: A Split-mouth Randomized Controlled Trial. J Endod. 2018 May;44(5):689-693. doi: 10.1016/j.joen.2018.02.010. Epub 2018 Mar 20.

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