Citation Information :
Jeevanandan G, Govindaraju L, Subramanian EM, Priyadarshini P. Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial. Int J Clin Pediatr Dent 2021; 14 (1):88-96.
Background: One of the cardinal points to be considered during endodontic procedures in children is the measure of postoperative pain.
Aim and objective: To evaluate the quality of obturation and its effect on postoperative pain with three file systems in primary mandibular molars during 1 week follow-up.
Materials and methods: The study was conducted as a double-blinded randomized controlled trial. The participants between 6 years and 9 years old requiring a pulpectomy were recruited for the trial. Forty-five primary mandibular molars were randomly allocated into 15 teeth each in Hand K-files; Kedo-SH and Kedo-SG Blue groups. Wong Baker\'s FACES Pain Rating Scale was used for assessing the postoperative pain in the children for 1 week. Pearson\'s Chi-square test, Kruskal–Wallis test, and Mann–Whitney U test were used for analyzing the data statistically.
Results: Optimal fillings were observed more in the Kedo-SG Blue group (80.0%) compared to the other two groups (p < 0.017). On intergroup analysis, the Kedo-SG Blue group reported less postoperative pain compared to Kedo-SH group on day 1 while on day 7 no postoperative pain was experienced in either of the groups. Less postoperative pain was reported by the children in whom the canals were optimally filled compared to overfilling and underfilling.
Conclusion: Kedo-SG Blue resulted in less postoperative pain when compared to Kedo-SH and hand K-files, whereas optimally filled children experienced less postoperative pain compared to overfilling and underfilling.
Clinical significance: A felicitous pediatric dental practice includes appropriate assessment and management of postoperative pain in children. Hence, the present study is important in highlighting the affiliation of postoperative pain with quality of obturation following an endodontic intervention in children.
Garcia-Godoy F. Evaluation of an iodoform paste in root canal therapy for infected primary teeth. J Dent Child 1987;54(1):30–34.
Mohamed HAA. Pulpectomy procedures in primary molar teeth. Eur J Gen Dent 2014;3(1):3–10. DOI: 10.4103/2278-9626.126201.
Brothwell DJ. Guidelines on the use of space maintainers following premature loss of primary teeth. J Can Dent Assoc 1997;63(10):753–766.
Rahbaran S, Gilthorpe MS, Harrison SV, et al. Comparison of clinical outcome of periapical surgery in endodontic and oral surgery units of a teaching dental hospital: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91(6):700–709. DOI: 10.1067/moe.2001.114828.
Eleazer PD, Eleazer KR. Flare-up rate in pulpally necrotic molars in one-visit versus two-visit endodontic treatment. J Endod 1998;24(9):614–616. DOI: 10.1016/S0099-2399(98)80122-2.
Azar MR, Safi L, Nikaein A. Comparison of the cleaning capacity of Mtwo and Pro Taper rotary systems and manual instruments in primary teeth. Dent Res J (Isfahan) 2012;9(2):14651. DOI: 10.4103/1735-3327.95227.
Fuks AB. Pulp therapy for the primary dentition. In: Pinkham JR, Casamassimo PS, Mc Tigue DJ, et al., ed. Pediatric dentistry: infancy through adolescence. 4th ed., Philadelphia: WB Saunders Co; 2005. p. 390.
Bashetty K, Hegde J. Comparison of 2% chlorhexidine and 5.25% sodium hypochlorite irrigating solutions on postoperative pain: a randomized clinical trial. Indian J Dent Res 2010;21(4):523–527. DOI: 10.4103/0970-9290.74225.
Elmubarak AHH, Abu-Bakr NH, Ibrahim YE, et al. Postoperative pain in multiple-visit and single-visit root canal treatment. J Endod 2010;36(1):36–39. DOI: 10.1016/j.joen.2009.09.003.
Nekoofar MH, Sheykhrezae MS, Meraji N, et al. Comparison of the effect of root canal preparation by using Waveone and Protaper on postoperative pain: a randomized clinical trial. J Endod 2015;41(5):575–578. DOI: 10.1016/j.joen.2014.12.026.
Pasqualini D, Mollo L, Scotti N, et al. Postoperative pain after manual and mechanical glide path: a randomized clinical trial. J Endod 2012;38(1):32–36. DOI: 10.1016/j.joen.2011.09.017.
Alves VO. Endodontic flare-ups: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110(5):68–72. DOI: 10.1016/j.tripleo.2010.05.014.
Masoud P, Jalali S, Haghdoost AA, et al. Comparison of the effect of various irrigants on apically extruded debris after root canal preparation. J Endod 2012;38(1):21–27. DOI: 10.1111/j.1747-4477.2010.00268.x.
Pozos-Guillen A, Martinez-Rider R, Aguirre-Banuelos P, et al. Pre-emptive analgesic effect of tramadol after mandibular third molar extraction: a pilot study. J Oral Maxillofac Surg 2007;65(7):1315–1320. DOI: 10.1016/j.joms.2006.10.079.
Shafie L, Barghi H, Parirokh M, et al. Postoperative pain following pulpotomy of primary molars with two biomaterials: a randomized split mouth clinical trial. Iran Endod J 2017;12(1):10–14. DOI: 10.22037/iej.2017.02.
Subbiya A, Cherkas PS, Vivekanandhan P, et al. Effect of three different rotary instrumentation systems on postinstrumentation pain: a randomized clinical trial. J Conserv Dent 2017;20(6):467–473. DOI: 10.4103/JCD.JCD_350_16.
Ng YL, Glennon JP, Setchell DJ, et al. Prevalence of and factors affecting post-obturation pain in patients undergoing root canal treatment. Int Endod J 2004;37(6):381–391. DOI: 10.1111/j.1365-2591.2004.00820.x.
Chavez de Paz Villanueva LE. Fusobacterium nucleatum in endodontic flare-up. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93(2):179–183. DOI: 10.1067/moe.2002.120803.
Glennon JP, Ng YL, Setchell DJ, et al. Prevalence of and factors affecting post operation pain in patient undergoing two visit root canal treatment. Int Endod J 2004;37(1):29–37. DOI: 10.1111/j.1365-2591.2004.00748.x.
Alonso-Ezpeleta LO, Gasco-Garcia C, Castellanos-Cosano L, et al. 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;17(4):e721–e727. DOI: 10.4317/medoral.17898.
Makeeva IM, Turkina AIU. Effects of the method of mechanical root canal treatment on emergence of pain after endodontic management. Stomatologiia (Mosk) 2005;84(5):21–23.
Genet JM, Hart AA, Wesselink PR, et al. Preoperative and operative factors associated with pain after the first endodontic visit. Int Endod J 1987;20(2):53–64. DOI: 10.1111/j.1365-2591.1987.tb00590.x.
Shahi S, Asghari V, Rahimi S, et al. Postoperative pain after endodontic treatment of asymptomatic teeth using rotary instruments: a randomized clinical trial. Iran Endod J 2016;11(1):38–43. DOI: 10.7508/iej.2016.01.008.
Vaudt J, Bitter K, Neumann K, et al. Ex vivo study on root canal instrumentation of two rotary nickel-titanium systems in comparison to stainless steel hand instruments. Int Endod J 2009;42(1):22–33. DOI: 10.1111/j.1365-2591.2008.01489.x.
Talebzadeh B, Nezafati S, Rahimi S, et al. Comparison of manual and rotary instrumentation on postoperative pain in teeth with asymptomatic irreversible pulpitis: a randomized clinical trial. Iran Endod J 2016;11(4):273–279. DOI: 10.22037/iej.2016.4.
Gupta S, Dhir S, Thakur BD, et al. Comparison of the Incidence of post-operative pain and time taken for instrumentation using manual and rotary techniques and obturation in single-visit endodontics, in young permanent teeth - an in vivo study. Int J Oral Care Res 2018;6(2):S15–S18.
Topçuoğlu G, Topçuoğlu HS, Delikan E, et al. Postoperative pain after root canal preparation with hand and rotary files in primary molar teeth. Pediatr Dent 2017;39(3):192–196.
Nair M, Jeevanandan G, Vignesh R, et al. Comparative evaluation of post-operative pain after pulpectomy with K-files, Kedo-S files and MTwo files in deciduous molars – a randomized clinical trial. Braz Dent Sci 2018;21(4):411–417. DOI: 10.14295/bds.2018.v21i4.1617.
Panchal V, Jeevanandan G, Subramanian EM. Comparison of post-operative pain after root canal instrumentation with hand K-files, H-files and rotary Kedo-S files in primary teeth: a randomized clinical trial. Eur Arch Paediatr Dent 2019;20(5):467–472. DOI: 10.1007/s40368-019-00429-5.
Altman DG, Schulz KF, Moher D, et al. The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med 2001;134(8):663–694. DOI: 10.7326/0003-4819-134-8-200104170-00012.
Parirokh M, Yosefi MH, Nakhaee N, et al. Effect of bupivacaine on postoperative pain for inferior alveolar nerve block anesthesia after single-visit root canal treatment in teeth with irreversible pulpitis. J Endod 2012;38(8):1035–1039. DOI: 10.1016/j.joen.2012. 04.012.
Garra G, Singer AJ, Taira BR, et al. Validation of the Wong-Baker FACES pain rating scale in pediatric emergency department patients. Acad Emerg Med 2010;17(1):51–54. DOI: 10.1111/j.1553-2712.2009.00620.x.
Coll JA, Sadrian R. Predicting pulpectomy success and its relationship to exfoliation and succedaneous dentition. Pediatr Dent 1996;18(1):57–63.
Gutmann JL, Lovdahl PE. Problems in the assessment of success and failure, quality assurance, and their integration into endodontic treatment planning. In: Gutmann JL, Dumsha TC, Lovdahl PE, et al., ed. Problem Solving In Endodontics. 3rd ed., St. Louis, MO: Elsevier; 1997. pp. 1–22.
Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in single and multiple visit endodontic treatment: a systematic review. Int Endod J 2008;41(2):91–99. DOI: 10.1111/j.1365-2591.2007.01316.x.
Ince B, Ercan E, Dalli M, et al. Incidence of postoperative pain after single-and multi-visit endodontic treatment in teeth with vital and non-vital pulp. Eur J Dent Oct 2009;3(4):273–279. DOI: 10.1055/s-0039-1697444.
Seltzer S, Naidorf IJ. Flare-ups in endodontics: I. Etiologicalfactors. J Endod 1985;30(7):476–481. DOI: 10.1097/00004770-200407000-00005 discussion 5, 2004; 30(7): 476-481.
Barr ES, Kleier DJ, Barr NV. Use of nickel-titanium rotary files for root canal preparation in primary teeth. Pediatr Dent 2000;22(1):77–78.
Jeevanandan G. Kedo S paediatric rotary files for root canal preparation in primary teeth - case report. J Clin Diagn Res 2017;11(3):ZR03–ZR05. DOI: 10.7860/JCDR/2017/25856.9508.
Mangalam S, Rao CV, Lakshminarayanan L. Evaluation of apically extruded debris and irrigant using three instrumentation techniques. Endodontology 2002;14:19–23.
Reddy S, Hicks L. Apical extrusion of debris using two hand and two rotary instrumentation techniques. J Endod 1998;24(3):180–183. DOI: 10.1016/S0099-2399(98)80179-9.
Erasquin J, Muruzabal M. Root canal fillings with zinc oxide eugenol in the rat molar. Oral Surg Oral Med Oral Pathol 1967;24(4):547–558. DOI: 10.1016/0030-4220(67)90436-7.